Provider Demographics
NPI:1326248766
Name:DAVID K. SMITH M D LLC
Entity Type:Organization
Organization Name:DAVID K. SMITH M D LLC
Other - Org Name:MT PLEASANT PRIMARY CARE FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-971-8180
Mailing Address - Street 1:1300 HOSPITAL DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3261
Mailing Address - Country:US
Mailing Address - Phone:843-971-8180
Mailing Address - Fax:843-971-9239
Practice Address - Street 1:1300 HOSPITAL DR
Practice Address - Street 2:SUITE 250
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3261
Practice Address - Country:US
Practice Address - Phone:843-971-8180
Practice Address - Fax:843-971-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8893207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3545Medicaid
SCD182837453OtherMEDICARE LEGACY
SCD18283Medicare UPIN
SC7453Medicare PIN