Individual
TIMOTHY EARL SMITH
Active
Individual
TIMOTHY EARL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9501423
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9501423
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1231C
BCBS
—
05
—
2004385000
—
WV
01
—
31886
PARTNERS
—
01
—
50086899
RR MEDICARE
—
05
—
5715920
—
VA
01
—
7379617
AETNA
—
01
—
87395
MEDCOST
—
05
—
891231C
—
NC
05
—
Q01426
—
SC
Enumeration date
12/13/2005
Last updated
09/08/2017
Update your record
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