| Physician Services Llc | |
|
214 Lake Front Drive Physician Services Cola SC 29212 | |
| (803) 309-4788 | |
| (866) 927-3065 |
| Full Name | Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 214 Lake Front Drive, Cola, South Carolina |
| Authorized Official Name and Position | Charmaine M George (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8033094788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Services Llc 214 Lake Front Drive Cola SC 29212 Ph: () - | Physician Services Llc 214 Lake Front Drive Physician Services Cola SC 29212 Ph: (803) 309-4788 |
| NPI Number | 1417209982 |
|---|---|
| Provider Enumeration Date | 10/09/2012 |
| Last Update Date | 11/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417209982 | NPI | - | NPPES |
| GP6800 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |