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103 Summit Centre Drive Columbia SC 29229 | |
(803) 382-2450 | |
(803) 382-2469 |
Full Name | |
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Speciality | Family Medicine |
Location | 103 Summit Centre Drive, Columbia, South Carolina |
Authorized Official Name and Position | Tiffany Ayers (CREDENTIALING MANAGER) |
Authorized Official Contact | 8039358292 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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470 Hulon Lane Attn: Vp - Revenue Cycle West Columbia SC 29169 Ph: (803) 382-2450 | 103 Summit Centre Drive Columbia SC 29229 Ph: (803) 382-2450 |
NPI Number | 1760948863 |
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Provider Enumeration Date | 02/13/2019 |
Last Update Date | 05/02/2019 |
Identifier | Type | State | Issuer |
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1760948863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | 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 | |