Provider Demographics
NPI:1487280061
Name:SMYTHE, MEREDITH D
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:D
Last Name:SMYTHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 CHESLEY LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1461
Mailing Address - Country:US
Mailing Address - Phone:919-869-6089
Mailing Address - Fax:
Practice Address - Street 1:11312 US 15 501 N STE 401
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6377
Practice Address - Country:US
Practice Address - Phone:919-933-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist