Physician Services Llc | |
214 Lake Front Drive Physician Services Cola SC 29212 | |
(803) 309-4788 | |
(866) 927-3065 |
Full Name | Physician Services Llc |
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Speciality | Internal Medicine |
Location | 214 Lake Front Drive, Cola, South Carolina |
Authorized Official Name and Position | Charmaine M George (OWNER/PHYSICIAN) |
Authorized Official Contact | 8033094788 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Physician Services Llc 214 Lake Front Drive Cola SC 29212 Ph: () - | Physician Services Llc 214 Lake Front Drive Physician Services Cola SC 29212 Ph: (803) 309-4788 |
NPI Number | 1417209982 |
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Provider Enumeration Date | 10/09/2012 |
Last Update Date | 11/22/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417209982 | NPI | - | NPPES |
GP6800 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |