Individual
LORELI MUNFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 AIRPORT BLVD, WEST COLUMBIA, SC 29169-5016
(803) 380-6399
(877) 484-7187
Mailing address
1612 AIRPORT BLVD, WEST COLUMBIA, SC 29169-5016
(803) 380-6399
(877) 484-7187
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-120782
IL
207R00000X
Internal Medicine Physician
Primary
28414
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-120782
ILLINOIS STATE LICENSE
IL
05
—
284141
—
SC
Enumeration date
05/03/2006
Last updated
03/25/2026
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