Provider Demographics
NPI:1871548123
Name:SMITH, JAMES D (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4566
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:864-797-6195
Practice Address - Street 1:200 PATEWOOD DR
Practice Address - Street 2:STE A10
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-454-2222
Practice Address - Fax:864-235-6655
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC5561207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00265793OtherRR MEDICARE
SC576007863136OtherBLUECHOICE HEALTHPLAN ID
SC576007863174OtherBCBS OF SC ID
SC055611Medicaid
SCD056776904Medicare PIN
SC576007863174OtherBCBS OF SC ID