Provider Demographics
NPI:1871549410
Name:SMITH, ALLISON C (MD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:C
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:214 LITTLE PALM LOOP
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6622
Mailing Address - Country:US
Mailing Address - Phone:843-723-3441
Mailing Address - Fax:843-805-4040
Practice Address - Street 1:214 LITTLE PALM LOOP
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6622
Practice Address - Country:US
Practice Address - Phone:843-723-3441
Practice Address - Fax:843-805-4040
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20540207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT44413Medicaid
SCF798331459Medicare PIN
F79833Medicare UPIN