Organization
COLONIAL FAMILY PRACTICE, LLC
Active
Other names
CFP Forest Acres 101, Colonial Family Practice Columbia
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GLENN WHALEY MD (PARTNER)
(803) 773-5227
Entity
Organization
Contact information
Practice address
4700 FOREST DR, SUITE 101, COLUMBIA, SC 29206
(803) 256-1511
(803) 256-7333
Mailing address
325 BROAD ST STE 100, SUMTER, SC 29150-4167
(803) 773-5227
(803) 773-5227
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
363A00000X
Physician Assistant
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP 3564
—
SC
Enumeration date
02/20/2014
Last updated
10/02/2019
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