Organization
PREMIER PHYSICIAN GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEZMOND SUMTER MD (PHYSICIAN)
(803) 381-2869
Entity
Organization
Contact information
Practice address
110 ATRIUM WAY, COLUMBIA, SC 29223-6301
(803) 381-2869
(864) 484-8587
Mailing address
2818 PARK ST, COLUMBIA, SC 29201-1645
(803) 381-2869
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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