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Organization
CAROLINA FAMILY PRACTICE
Active
Organization
CAROLINA FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM D. ANDERSON III MD (CMO)
(803) 777-3861
Entity
Organization
Contact information
Practice address
1410 BLANDING ST STE 102, COLUMBIA, SC 29201
(803) 256-2500
(803) 777-2027
Mailing address
PO BOX 5731, COLUMBIA, SC 29250-5731
(803) 256-2500
(803) 758-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3197
—
SC
Enumeration date
07/07/2006
Last updated
06/08/2018
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