| NPI | 1689006652 |
|---|---|
| Doing Business As | COLONIAL FAMILY PRACTICE MANNING |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Manager 803-773-5227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 13915) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2021-03-22 |