Smith, Elton Travis

Smith, Elton Travis is an individual health care provider with primary practice located at 10628 Park Rd , Charlotte NC 28210-8407. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Smith, Elton Travis can be contacted via phone (704) 973-5500.

Contact Information

Primary practice address
10628 Park Rd Charlotte NC 28210-8407
Phone: (704) 973-5500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 9401109 North Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 9401109 North Carolina

Profile Details

NPI number 1487653416
LBN Legal business name Smith, Elton Travis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Nov 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1487653416 NPPES
South Carolina Other 18494 STATE MEDICAL BOARD
South Carolina MEDICAID 184945 STATE MEDICAL BOARD
South Carolina MEDICAID 5904987 STATE MEDICAL BOARD
South Carolina Other 9401109 STATE MEDICAL BOARD

Popular Providers