| Excelsior Medical Clinic, Pa | |
|
448 N Main St Excelsior Medical Clinic, Pa Sumter SC 29150-4233 | |
| (803) 778-2429 | |
| (803) 773-6303 |
| Full Name | Excelsior Medical Clinic, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 448 N Main St, Sumter, South Carolina |
| Authorized Official Name and Position | Joseph Cecil Williams (PRESIDENT) |
| Authorized Official Contact | 8037782429 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excelsior Medical Clinic, Pa 448 N Main St Excelsior Medical Clinic, Pa Sumter SC 29150-4233 Ph: (803) 778-2429 | Excelsior Medical Clinic, Pa 448 N Main St Excelsior Medical Clinic, Pa Sumter SC 29150-4233 Ph: (803) 778-2429 |
| NPI Number | 1588618144 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 10/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588618144 | NPI | - | NPPES |
| PA5850 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9647 (South Carolina) | Primary |
| 208D00000X | General Practice | 9646 (South Carolina) | Secondary |
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