Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | T00000 | SC |
Y | 207VG0400X | Gynecologist | 31355 | SC |
NPI | 1205043445 |
---|---|
Provider Name | Abigail S Smith |
First Address | West Columbia, SC 29171-6069 |
Second Address | Columbia, SC 29201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 11/11/2020 |