Basic Information
| Provider Information | |||||||||
| NPI: | 1659311538 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76 PEACHTREE ROAD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288033505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282743477 | ||||||||
| FaxNumber: | 8282747407 | ||||||||
| Practice Location | |||||||||
| Address1: | 76 PEACHTREE ROAD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288033505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282743477 | ||||||||
| FaxNumber: | 8282747407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 11/06/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 053176 | GA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 9600206 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 756303758C | 05 | GA | MEDICAID | 756303758E | 05 | GA | MEDICAID | 756303758M | 05 | GA | MEDICAID | 756303758D | 05 | GA | MEDICAID | 756303758F | 05 | GA | MEDICAID | 756303758G | 05 | GA | MEDICAID | 756303758O | 05 | GA | MEDICAID | 756303758L | 05 | GA | MEDICAID | 756303758H | 05 | GA | MEDICAID | 756303758J | 05 | GA | MEDICAID | 756303758K | 05 | GA | MEDICAID |