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NPI 1265628234

NPI 1265628234 : ABNER CREEK FAMILY MEDICINE, INC. : CHESTER, SC

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General NPI Number Information
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    NPI Number           |    1265628234
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABNER CREEK FAMILY MEDICINE, INC. 
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Dates
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    Enumeration Date     |    09/24/2007
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    Last Update Date     |    03/12/2008
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Provider Practice Location Address
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    Address Line         |    1 MEDICAL PARK DR 
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    City                 |    CHESTER
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    State                |    SC
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    Zip                  |    29706-9769
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    Country              |    US
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    Telephone            |    803-581-3163
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    Fax                  |    803-385-5388
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Provider Business Mailing Address
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    Address Line         |    1 MEDICAL PARK DR 
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    City                 |    CHESTER
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    State                |    SC
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    Zip                  |    29706-9769
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    Country              |    US
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    Telephone            |    803-581-3163
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    Fax                  |    803-385-5388
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Authorized Official
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    Title or Position    |    OWNER/PRESIDENT
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    Name                 |    DR. DANIEL R CROW 
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    Credential           |    M.D.
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    Telephone            |    803-581-3163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    17336
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    License Number State |    SC
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