Colonial Family Practice, LLC

NPI #1497060719 in Sumter, South Carolina

Provider Information

NPI Number
1497060719
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
Aug 11, 2010
Last Updated
Mar 22, 2021

Practice Location

Address
308 W WESMARK BLVD
City
Sumter
ZIP Code
29150
Phone
(803) 773-5227

Authorized Official

Name
MRS. STEPHANIE K DISHER
Title
CREDENTIALING SPECIALIST
Phone
(803) 773-5227

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily
Family Medicine

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