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5000 Thurmond Mall Suite 207 Columbia SC 29201 | |
(803) 233-3420 | |
(803) 753-9788 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 5000 Thurmond Mall, Columbia, South Carolina |
Authorized Official Name and Position | Richard Z Cheng (DIRECTOR) |
Authorized Official Contact | 8032333420 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5000 Thurmond Mall Suite 207 Columbia SC 29201 Ph: (803) 233-3420 | 5000 Thurmond Mall Suite 207 Columbia SC 29201 Ph: (803) 233-3420 |
NPI Number | 1982801197 |
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Provider Enumeration Date | 06/29/2007 |
Last Update Date | 07/27/2007 |
Identifier | Type | State | Issuer |
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1982801197 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 22790 (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 | |