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2711 Colonial Dr Columbia SC 29203-6818 | |
(304) 429-1088 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 2711 Colonial Dr, Columbia, South Carolina |
Authorized Official Name and Position | Brandi Hatfield (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 3044291088 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 390 Huntington WV 25708-0390 Ph: () - | 2711 Colonial Dr Columbia SC 29203-6818 Ph: (304) 429-1088 |
NPI Number | 1174019111 |
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Provider Enumeration Date | 07/02/2018 |
Last Update Date | 07/02/2018 |
Identifier | Type | State | Issuer |
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1174019111 | 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 | |