Organization
COLONIAL FAMILY PRACTICE, LLC
Active
Other names
Colonial Family Practice Wesmark Court
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE KNIGHT DISHER (CREDENTIALING SPECIALIST)
(803) 773-5227
Entity
Organization
Contact information
Practice address
26 WESMARK CT, SUMTER, SC 29150-1996
(803) 773-5227
Mailing address
325 BROAD ST STE 100, SUMTER, SC 29150-4167
(803) 773-5227
(803) 746-7445
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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