Ballyamanda, Smitha M
Ballyamanda, Smitha M is an individual health care provider with primary practice located at 515 Rivercrossing Dr Suite 180, Fort Mill SC 29715-7900. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Ballyamanda, Smitha M can be contacted via phone (803) 578-2800.Contact Information
Primary practice address
515 Rivercrossing Dr Suite 180
Fort Mill SC 29715-7900
Phone: (803) 578-2800
Fax: (803) 578-2810
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2016-02043 | North Carolina |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 36544 | South Carolina |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 2016-02043 | North Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36544 | South Carolina |
Profile Details
| NPI number | 1932336542 |
|---|---|
| LBN Legal business name | Ballyamanda, Smitha M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2009 |
| Last updated | Jun 5th, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932336542 | NPPES |
| South Carolina | MEDICAID | 365447 |
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