Provider Demographics
NPI:1780860205
Name:SMYRE, HERBERT LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:LEE
Last Name:SMYRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SHEFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1025
Mailing Address - Country:US
Mailing Address - Phone:864-877-9560
Mailing Address - Fax:
Practice Address - Street 1:106 SHEFFIELD RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1025
Practice Address - Country:US
Practice Address - Phone:864-877-9560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC062192080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC062194Medicaid