1659311538 NPI number — MELANIE C SMITH MD

Table of content: MELANIE C SMITH MD (NPI 1659311538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659311538 NPI number — MELANIE C SMITH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
MELANIE
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659311538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
76 PEACHTREE ROAD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-3505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-274-3477
Provider Business Mailing Address Fax Number:
828-274-7407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
76 PEACHTREE ROAD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-3505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-274-3477
Provider Business Practice Location Address Fax Number:
828-274-7407
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  053176 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 9600206 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 756303758C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758M , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758F , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758O , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758L , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758J , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 756303758K , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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