Colonial Family Practice, LLC
NPI #1467999326 in Manning, South Carolina
Provider Information
- NPI Number
- 1467999326
- 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
- Jan 30, 2017
- Last Updated
- Mar 22, 2021
Practice Location
- Address
- 1013 PROFESSIONAL CT
- Address 2
- SUITE A
- City
- Manning
- State
- South Carolina
- ZIP Code
- 29102-2827
- Phone
- (803) 433-7425
Authorized Official
- Name
- MRS. STEPHANIE KNIGHT DISHER
- Title
- CREDENTIALING SPECIALIST
- Phone
- (803) 773-5227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
| Emergency Medicine |
| Obstetrics & Gynecology - Gynecology — Gynecology |
| General Practice |
| Nurse Practitioner |
| Nurse Practitioner - Adult Health — Adult Health |
| Nurse Practitioner - Pediatrics — Pediatrics |
| Family Medicine |
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