COLONIAL FAMILY PRACTICE LLC NPI 1508302308

NPI Information

  • NPI: 1508302308
  • Provider Name: COLONIAL FAMILY PRACTICE, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: PRIMARY CARE AT SANTEE COOPER
  • CLIA Number: 42D0903300
  • Address: 1013 PROFESSIONAL CT
    SUITE C
    MANNING, SC
    ZIP 29102
  • Phone: (803) 433-7444

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NPI Details

COLONIAL FAMILY PRACTICE, LLC is a family medicine in Manning, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. COLONIAL FAMILY PRACTICE, LLC NPI is 1508302308. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Primary Care At Santee Cooper.

The provider's business location address is:

1013 PROFESSIONAL CT
SUITE C
MANNING, SC
ZIP 29102-827
Phone: (803) 433-7444
Fax: (803) 418-0202

The provider's authorized official is Brad Mcintosh .
The authorized official title is Office Manager and has the following contact phone number (803) 433-7444.

The CLIA number assigned to this NPI record is 42D0903300 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/17/2017 and was last updated on 1/17/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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