Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Marion Primary Care

Organization Family Medicine Physician · NPI 1912964479

Lake Marion Primary Care is a Family Medicine Physician in Manning, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
Specialties on file
2

Practice location Address checks out

15 E Hospital St
Manning, SC 29102-3152
Phone: (803) 435-2529
Fax: (803) 435-4196
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 20345 (SC)
Family Medicine Physician Taxonomy 207Q00000X · Licence 13275 (SC)

Record details

NPI number1912964479
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Saundra Wallace — Administrator · (803) 435-2529
NPI enumeratedApril 27, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address15 E Hospital St, Manning, SC 29102-3152

Other providers in Manning