Healthcare Provider Details

I. General information

NPI: 1952470643
Provider Name (Legal Business Name): NEW DAY FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N WOODLAND DR STE D
LANCASTER SC
29720-4778
US

IV. Provider business mailing address

820 W MEETING ST
LANCASTER SC
29720-2202
US

V. Phone/Fax

Practice location:
  • Phone: 803-285-5441
  • Fax: 803-285-7509
Mailing address:
  • Phone: 803-285-5441
  • Fax: 803-285-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DEBBIE T BREWER
Title or Position: DIRECTOR OF PROVIDER ENROLLMENT
Credential:
Phone: 615-465-7626