NPI | 1174257067 |
---|---|
Doing Business As | COLONIAL FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Manager 803-773-5227 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363LA2200X Nurse Practitioner, Adult Health | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-07-15 |
Last Update Date | 2022-07-15 |