| Springwood Lake Family Practice | |
|
1721 Horseshoe Dr Columbia SC 29223-6281 | |
| (803) 779-1420 | |
| (803) 931-0676 |
| Full Name | Springwood Lake Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1721 Horseshoe Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Stephen F Serbin (CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 8037791420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Springwood Lake Family Practice 1910 Gregg St Columbia SC 29201-2618 Ph: (803) 779-1420 | Springwood Lake Family Practice 1721 Horseshoe Dr Columbia SC 29223-6281 Ph: (803) 779-1420 |
| NPI Number | 1568555753 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 06/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568555753 | NPI | - | NPPES |
| GP3424 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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