Provider Demographics
NPI:1619261393
Name:SMITH, ANDREA COVER (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:COVER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0287
Mailing Address - Country:US
Mailing Address - Phone:864-233-1534
Mailing Address - Fax:864-751-0479
Practice Address - Street 1:1588 GEER HWY
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-9204
Practice Address - Country:US
Practice Address - Phone:864-836-1109
Practice Address - Fax:864-836-6365
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine