Carolina Family Practice | |
1410 Blanding St Ste 102 Columbia SC 29201 | |
(803) 256-2500 | |
(803) 777-2027 |
Full Name | Carolina Family Practice |
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Speciality | Nurse Practitioner |
Location | 1410 Blanding St Ste 102, Columbia, South Carolina |
Authorized Official Name and Position | William D. Anderson (CMO) |
Authorized Official Contact | 8037773861 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Carolina Family Practice Po Box 5731 Columbia SC 29250-5731 Ph: (803) 256-2500 | Carolina Family Practice 1410 Blanding St Ste 102 Columbia SC 29201 Ph: (803) 256-2500 |
NPI Number | 1063444347 |
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Provider Enumeration Date | 07/07/2006 |
Last Update Date | 06/08/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063444347 | NPI | - | NPPES |
GP3197 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |