| Colonial Family Practice Ne | |
|
11 Gateway Corners Park Columbia SC 29203-8902 | |
| (803) 773-5227 | |
| (803) 462-0375 |
| Full Name | Colonial Family Practice Ne |
|---|---|
| Speciality | Family Medicine |
| Location | 11 Gateway Corners Park, Columbia, South Carolina |
| Authorized Official Name and Position | Leslie M. Alexander (CREDENTIALING) |
| Authorized Official Contact | 8037735227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Family Practice Ne 325 Broad St Suite 100 Sumter SC 29150-4167 Ph: (803) 773-5227 | Colonial Family Practice Ne 11 Gateway Corners Park Columbia SC 29203-8902 Ph: (803) 773-5227 |
| NPI Number | 1285066233 |
|---|---|
| Provider Enumeration Date | 08/01/2013 |
| Last Update Date | 10/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285066233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | 25856 (South Carolina) | Primary |
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