Colonial Family Practice, LLC
NPI #1336810175 in Sumter, South Carolina
Provider Information
- NPI Number
- 1336810175
- Entity Type
- Organization
- Organization Name
- Colonial Family Practice, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COLONIAL FAMILY PRACTICE, LLC
- Primary Specialty
- Psychiatry & Neurology - Child & Adolescent Psychiatry
- Enumeration Date
- Sep 22, 2021
- Last Updated
- Sep 22, 2021
Practice Location
- Address
- 696 BULTMAN DR.
- City
- Sumter
- State
- South Carolina
- ZIP Code
- 29150-2549
- Phone
- (803) 773-5227
Authorized Official
- Name
- STEPHANIE KNIGHT DISHER
- Title
- CREDENTIALING MANAGER
- Phone
- (803) 773-5227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Counselor - Mental Health — Mental Health |
| Counselor - Professional — Professional |
| Psychiatry & Neurology - Child & Adolescent Psychiatry — Child & Adolescent Psychiatry |
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| DR. Kim James Masters, MD | |
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