| Dutch Fork Family Practice | |
|
110 Dutchman Blvd. Irmo SC 29063 | |
| (803) 732-8370 | |
| (803) 732-8373 |
| Full Name | Dutch Fork Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 110 Dutchman Blvd., Irmo, South Carolina |
| Authorized Official Name and Position | Michelle Archer (OWNER) |
| Authorized Official Contact | 8037328370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dutch Fork Family Practice 110 Dutchman Blvd. Irmo SC 29063 Ph: (803) 732-8370 | Dutch Fork Family Practice 110 Dutchman Blvd. Irmo SC 29063 Ph: (803) 732-8370 |
| NPI Number | 1083761316 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083761316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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