| Colonial Pediatrics | |
|
742 W Liberty St Sumter SC 29150-4746 | |
| (803) 773-5227 | |
| (803) 774-5400 |
| Full Name | Colonial Pediatrics |
|---|---|
| Speciality | Pediatrics |
| Location | 742 W Liberty St, 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 Pediatrics 325 Broad St Suite 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | Colonial Pediatrics 742 W Liberty St Sumter SC 29150-4746 Ph: (803) 773-5227 |
| NPI Number | 1851547640 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 03/22/2021 |
| Certification Date | 03/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851547640 | NPI | - | NPPES |
| GP3564 | Medicaid | SC |
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