Colonial Family Practice, LLC
NPI #1497178131 in Sumter, South Carolina
Provider Information
- NPI Number
- 1497178131
- Entity Type
- Organization
- Organization Name
- Colonial Family Practice, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jan 31, 2014
- Last Updated
- Dec 15, 2020
Practice Location
- Address
- 698 BULTMAN DR
- Address 2
- SUITE A
- City
- Sumter
- State
- South Carolina
- ZIP Code
- 29150
- Phone
- (803) 773-5227
Authorized Official
- Name
- STEPHANIE K DISHER
- Title
- CREDENTIALING SPECIALIST
- Phone
- (803) 773-5227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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