Provider Demographics
NPI:1174100762
Name:SMITH, APRIL NICOLE (DO)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 HOLIDAY RD # B
Mailing Address - Street 2:
Mailing Address - City:MC CORMICK
Mailing Address - State:SC
Mailing Address - Zip Code:29835-3430
Mailing Address - Country:US
Mailing Address - Phone:864-391-5011
Mailing Address - Fax:
Practice Address - Street 1:207 HOLIDAY RD # B
Practice Address - Street 2:
Practice Address - City:MC CORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835-3430
Practice Address - Country:US
Practice Address - Phone:864-391-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC89724207Q00000X
SCMDO.89724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program