NPI | 1497060719 |
---|---|
Doing Business As | COLONIAL FAMILY PRACTICE WESMARK |
Entity Type | Organization |
Authorized Contact | STEPHANIE K DISHER Credentialing Specialist 803-773-5227 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 3006640) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2010-08-11 |
Last Update Date | 2021-03-22 |