Colonial Family Practice, Llc | |
696 Bultman Dr. Sumter SC 29150-2549 | |
(803) 773-5227 | |
Not Available |
Full Name | Colonial Family Practice, Llc |
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Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
Location | 696 Bultman Dr., Sumter, South Carolina |
Authorized Official Name and Position | Stephanie Knight Disher (CREDENTIALING MANAGER) |
Authorized Official Contact | 8037735227 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Colonial Family Practice, Llc 674 W Liberty St Sumter SC 29150-4882 Ph: (803) 773-5227 | Colonial Family Practice, Llc 696 Bultman Dr. Sumter SC 29150-2549 Ph: (803) 773-5227 |
NPI Number | 1336810175 |
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Provider Enumeration Date | 09/22/2021 |
Last Update Date | 09/22/2021 |
Certification Date | 09/03/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336810175 | NPI | - | NPPES |
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