Organization
UPSTATE FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL K COLVIN MD (OWNER)
(864) 882-6141
Entity
Organization
Contact information
Practice address
109 OMNI DR, SUITE B, SENECA, SC 29672-9448
(864) 882-6141
(864) 882-6680
Mailing address
109 OMNI DR, SUITE B, SENECA, SC 29672-9448
(864) 882-6141
(864) 882-6680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/15/2006
Last updated
08/22/2020
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