| Colonial Family Practice Liberty Street Location | |
|
674 W Liberty St Sumter SC 29150-4882 | |
| (803) 773-5227 | |
| Not Available |
| Full Name | Colonial Family Practice Liberty Street Location |
|---|---|
| Speciality | Family Medicine |
| Location | 674 W Liberty St, Sumter, South Carolina |
| Authorized Official Name and Position | Stephanie Knight Disher (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8037735227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Family Practice Liberty Street Location 325 Broad St Ste 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | Colonial Family Practice Liberty Street Location 674 W Liberty St Sumter SC 29150-4882 Ph: (803) 773-5227 |
| NPI Number | 1225687338 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 01/30/2020 |
| Medicare PECOS PAC ID | 9931017118 |
|---|---|
| Medicare Enrollment ID | O20200921002844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225687338 | NPI | - | NPPES |
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