| Colleton Internal Medicine | |
|
415 B Robertson Blvd Walterboro SC 29488-5713 | |
| (843) 542-9530 | |
| (843) 542-9532 |
| Full Name | Colleton Internal Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 415 B Robertson Blvd, Walterboro, South Carolina |
| Authorized Official Name and Position | Peter S Carnohan (PHYSICIAN) |
| Authorized Official Contact | 8435429530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleton Internal Medicine 415 B Robertson Blvd Walterboro SC 29488-5713 Ph: (843) 542-9530 | Colleton Internal Medicine 415 B Robertson Blvd Walterboro SC 29488-5713 Ph: (843) 542-9530 |
| NPI Number | 1164476735 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164476735 | NPI | - | NPPES |
| GP4312 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 22695 (South Carolina) | Primary |
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