Organization
SENECA FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE M KIDD (OFFICE MANAGER)
(864) 882-7400
Entity
Organization
Contact information
Practice address
867 WHITWORTH CIR, SENECA, SC 29672-9435
(864) 882-7400
(864) 882-7401
Mailing address
867 WHITWORTH CIR, SENECA, SC 29672-9435
(864) 882-7400
(864) 882-7401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RHC150
MEDICAID RURAL HEALTH
SC
Enumeration date
12/21/2006
Last updated
01/22/2008
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