Provider Demographics
NPI:1427473990
Name:SMITH, SEAN WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:WILLIAM
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 CAPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4514
Mailing Address - Country:US
Mailing Address - Phone:919-878-8848
Mailing Address - Fax:919-878-8863
Practice Address - Street 1:2926 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4514
Practice Address - Country:US
Practice Address - Phone:919-878-8848
Practice Address - Fax:919-878-8863
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor