Sean Smith

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Wingate, NC

NPI 1760935704 · NPPES record last updated Jul 26, 2016

Key facts

NPI
1760935704
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
415 Witmore Rd
Wingate, NC 28174-9710
Phone
(704) 221-5456
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

415 Witmore Rd
Wingate, NC 28174-9710

Mailing address

415 Witmore Rd
Wingate, NC 28174-9710
Phone (704) 221-5456

Other providers in Wingate, NC

All providers in Wingate, NC · Student in an Organized Health Care Education/Training Program in North Carolina

Sources for this page

Verify at the official NPI Registry.