| NPI | 1851547640 |
|---|---|
| Doing Business As | COLONIAL PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KNIGHT DISHER Credentialing Manager 803-773-5227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 3004950) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5499) |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2021-03-22 |