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Organization
COLONIAL FAMILY PRACTICE NE
Active
Organization
COLONIAL FAMILY PRACTICE NE
Active
Parent organization
COLONIAL FAMILY PRACTICE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLONIAL FAMILY PRACTICE, LLC
Authorized official
MS. LESLIE M. ALEXANDER (CREDENTIALING)
(803) 773-5227
Entity
Organization
Contact information
Practice address
11 GATEWAY CORNERS PARK, COLUMBIA, SC 29203-8902
(803) 773-5227
(803) 462-0375
Mailing address
325 BROAD ST, SUITE 100, SUMTER, SC 29150-4167
(803) 773-5227
(803) 753-9121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25856
SC
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
08/01/2013
Last updated
10/02/2013
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