Provider Demographics
NPI:1659311538
Name:SMITH, MELANIE C (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:C
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 1:76 PEACHTREE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3505
Mailing Address - Country:US
Mailing Address - Phone:828-274-3477
Mailing Address - Fax:828-274-7407
Practice Address - Street 1:76 PEACHTREE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3505
Practice Address - Country:US
Practice Address - Phone:828-274-3477
Practice Address - Fax:828-274-7407
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053176207L00000X
NC9600206207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA756303758CMedicaid
GA756303758EMedicaid
GA756303758MMedicaid
GA756303758DMedicaid
GA756303758FMedicaid
GA756303758GMedicaid
GA756303758OMedicaid
GA756303758LMedicaid
GA756303758HMedicaid
GA756303758JMedicaid
GA756303758KMedicaid
05BDKBXMedicare ID - Type Unspecified
GA756303758KMedicaid
GA756303758OMedicaid