Provider Demographics
NPI:1295362903
Name:SMOAK, NARDINE (MD)
Entity Type:Individual
Prefix:
First Name:NARDINE
Middle Name:
Last Name:SMOAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NARDINE
Other - Middle Name:MDM
Other - Last Name:ABDELSAYED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:101 CHAPMAN HILL RD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2194
Practice Address - Country:US
Practice Address - Phone:864-653-4071
Practice Address - Fax:864-653-4074
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine