Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 18070 | SC |
NPI | 1669442927 |
---|---|
Provider Name | Daniel Mouzon Smith JR. |
First Address | Greenville, SC 29615-4545 |
Second Address | Seneca, SC 29672-6743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 01/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1669442927 | NPI (01) | |
180707 | (05) | SC |
G23749 | (02) | SC |
GP4697 | (05) | SC |