Organization · Type 2 NPI

Colonial Family Practice, LLC

Family Medicine Physician · Eastover, SC

NPI number 1336725209 Active

Practice location

10441 Garners Ferry Rd
Eastover, SC 29044-9351

Call (803) 773-5227 Map

Mailing address

674 W Liberty St
Sumter, SC 29150-4882

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Physician Assistant	363A00000X	None listed
Medical Physician Assistant	363AM0700X	None listed
Nurse Practitioner	363L00000X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

NPI record

NPI: 1336725209
Entity type: Organization (Type 2)
Issued: Mar 22, 2021
Last updated: Mar 22, 2021
Status: Active
Subpart: Yes of Colonial Family Practice, LLC

Other names

Colonial Family Practice Garners Ferry · doing business as

Authorized official

Mrs. Stephanie Knight Disher
Credentialing Manager
(803) 773-5227

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336725209

Colonial Family Practice, LLC's National Provider Identifier is 1336725209, issued on Mar 22, 2021. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Eastover, SC. The record was last updated on Mar 22, 2021.