| Colonial Family Practice, Llc | |
|
696 Bultman Dr. Sumter SC 29150-2549 | |
| (803) 773-5227 | |
| Not Available |
| Full Name | Colonial Family Practice, Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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