Provider Demographics
NPI:1922116250
Name:HARRAWAY-SMITH, CAROLYN L (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:L
Last Name:HARRAWAY-SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:LORAINE
Other - Last Name:HARRAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:930 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6967
Mailing Address - Country:US
Mailing Address - Phone:336-890-3200
Mailing Address - Fax:336-890-3290
Practice Address - Street 1:930 3RD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6967
Practice Address - Country:US
Practice Address - Phone:336-890-3200
Practice Address - Fax:336-890-3290
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056011207V00000X
TN41905207V00000X
NC2013-00964207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD264801600Medicaid
G32685Medicare UPIN
MD264801600Medicaid