Colonial Family Practice, LLC
NPI #1174257067 in Sumter, South Carolina
Provider Information
- NPI Number
- 1174257067
- Entity Type
- Organization
- Organization Name
- Colonial Family Practice, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COLONIAL FAMILY PRACTICE, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jul 15, 2022
- Last Updated
- Jul 15, 2022
Practice Location
- Address
- 325 BROAD ST STE 200
- City
- Sumter
- State
- South Carolina
- ZIP Code
- 29150-4167
- Phone
- (803) 773-5227
Authorized Official
- Name
- MRS. STEPHANIE KNIGHT DISHER
- Title
- CREDENTIALING MANAGER
- Phone
- (803) 773-5227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
| Nurse Practitioner - Adult Health — Adult Health |
| Nurse Practitioner - Family — Family |
| Family Medicine |
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