Colonial Family Practice Ne | |
11 Gateway Corners Park Columbia SC 29203-8902 | |
(803) 773-5227 | |
(803) 462-0375 |
Full Name | Colonial Family Practice Ne |
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Speciality | Family Medicine |
Location | 11 Gateway Corners Park, Columbia, South Carolina |
Authorized Official Name and Position | Leslie M. Alexander (CREDENTIALING) |
Authorized Official Contact | 8037735227 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Colonial Family Practice Ne 325 Broad St Suite 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | Colonial Family Practice Ne 11 Gateway Corners Park Columbia SC 29203-8902 Ph: (803) 773-5227 |
NPI Number | 1285066233 |
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Provider Enumeration Date | 08/01/2013 |
Last Update Date | 10/02/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285066233 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | 25856 (South Carolina) | 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 | |