| Providence Physician Practices Llc | |
|
2001 Laurel St Ste 300 Columbia SC 29204-1018 | |
| (803) 254-2786 | |
| Not Available |
| Full Name | Providence Physician Practices Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 Laurel St, Columbia, South Carolina |
| Authorized Official Name and Position | Kathy Teague (AVP, SECRETARY) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Physician Practices Llc 114 Gateway Corporate Blvd Ste 425 Columbia SC 29203-9740 Ph: (803) 865-4780 | Providence Physician Practices Llc 2001 Laurel St Ste 300 Columbia SC 29204-1018 Ph: (803) 254-2786 |
| NPI Number | 1689030595 |
|---|---|
| Provider Enumeration Date | 01/07/2016 |
| Last Update Date | 01/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689030595 | NPI | - | NPPES |
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