Organization
SUNSET FAMILY PRACTICE ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SMITH CREDENTIALING (CREDENTIALING COORDINATOR)
(919) 342-6842
Entity
Organization
Contact information
Practice address
1173 SUNSET BLVD, WEST COLUMBIA, SC 29169-6863
(803) 445-6349
(803) 794-4342
Mailing address
1173 SUNSET BLVD, WEST COLUMBIA, SC 29169-6863
(803) 445-6349
(803) 794-4342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Enumeration date
03/31/2014
Last updated
06/10/2014
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