Provider Demographics
NPI:1326020793
Name:SMITH, NANCY L (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2515 BOWMAN GRAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7215
Mailing Address - Country:US
Mailing Address - Phone:252-561-7992
Mailing Address - Fax:252-561-7993
Practice Address - Street 1:2515 BOWMAN GRAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7215
Practice Address - Country:US
Practice Address - Phone:252-561-7992
Practice Address - Fax:252-561-7993
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601479207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC220020378OtherRAILROAD MEDICARE
NC891004WMedicaid
NC1004WOtherBCBS NC
NC891004WMedicaid
NC2233707AMedicare PIN