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698 Bultman Dr Suite A Sumter SC 29150 | |
(803) 773-5227 | |
(803) 753-9312 |
Full Name | |
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Speciality | Family Medicine |
Location | 698 Bultman Dr, Sumter, South Carolina |
Authorized Official Name and Position | Stephanie K Disher (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 8037735227 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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325 Broad St Suite 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | 698 Bultman Dr Suite A Sumter SC 29150 Ph: (803) 773-5227 |
NPI Number | 1497178131 |
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Provider Enumeration Date | 01/31/2014 |
Last Update Date | 12/15/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497178131 | NPI | - | NPPES |
GP3564 | Medicaid | SC | |
42D2126583 | Other | SC | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 17676 (South Carolina) | Primary |
Sumter Internal Medicine Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12 Barnette Dr, Sumter, SC 29150 Phone: 803-773-5442 Fax: 803-778-2394 | |
Colonial Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Broad St Ste 200, Sumter, SC 29150 Phone: 803-773-5227 Fax: 803-418-0202 | |
Invostix Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 E Wesmark Blvd Ste 2, Sumter, SC 29150 Phone: 803-757-1238 | |