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General NPI Number Information
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NPI Number | 1518995539
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Entity Type | Organization
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Legal Business Name | BLUFFTON FAMILY PRACTICE PA
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 16 MINUTEMAN DR
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City | BLUFFTON
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State | SC
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Zip | 29910
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Country | US
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Telephone | 843-757-9838
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Fax | 843-757-9667
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Provider Business Mailing Address
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Address Line | PO BOX 3066
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City | BLUFFTON
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State | SC
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Zip | 29910-3066
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Country | US
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Telephone | 843-757-9838
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Fax | 843-757-5966
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT DOUGLAS CONDIE
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Credential | MD
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Telephone | 843-757-9838
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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 |
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License Number State |
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