Provider Demographics
NPI:1588280077
Name:SMITH, STEPHEN BROOKS (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BROOKS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MEDICAL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5197
Mailing Address - Country:US
Mailing Address - Phone:828-437-4211
Mailing Address - Fax:
Practice Address - Street 1:103 MEDICAL HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5197
Practice Address - Country:US
Practice Address - Phone:828-437-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351046962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine