| Carolina Family Practice | |
|
1410 Blanding St Ste 102 Columbia SC 29201 | |
| (803) 256-2500 | |
| (803) 777-2027 |
| Full Name | Carolina Family Practice |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1410 Blanding St Ste 102, Columbia, South Carolina |
| Authorized Official Name and Position | William D. Anderson (CMO) |
| Authorized Official Contact | 8037773861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Family Practice Po Box 5731 Columbia SC 29250-5731 Ph: (803) 256-2500 | Carolina Family Practice 1410 Blanding St Ste 102 Columbia SC 29201 Ph: (803) 256-2500 |
| NPI Number | 1063444347 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 06/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063444347 | NPI | - | NPPES |
| GP3197 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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