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Individual

JENNIFER SOMMERVILLE COLBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1686 SKYLYN DR, SUITE 201, SPARTANBURG, SC 29307-1079
(864) 582-8135
(864) 573-9757
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27223
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
272234
SC
01
576007863102
BCBS
SC
Enumeration date
07/05/2006
Last updated
08/01/2013
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