| Between The Lakes Family Practice, Pa | |
|
106 Ram Cat Aly Seneca SC 29678-3244 | |
| (864) 888-4445 | |
| (864) 888-4345 |
| Full Name | Between The Lakes Family Practice, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 106 Ram Cat Aly, Seneca, South Carolina |
| Authorized Official Name and Position | Daniel Mouzon Smith (PRESIDENT) |
| Authorized Official Contact | 8648884445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Between The Lakes Family Practice, Pa 106 Ram Cat Aly Seneca SC 29678-3244 Ph: (864) 888-4445 | Between The Lakes Family Practice, Pa 106 Ram Cat Aly Seneca SC 29678-3244 Ph: (864) 888-4445 |
| NPI Number | 1356312995 |
|---|---|
| Provider Enumeration Date | 01/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356312995 | NPI | - | NPPES |
| GP3282 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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