Healthcare Provider Details

I. General information

NPI: 1295515260
Provider Name (Legal Business Name): METROPOLITAN COMMUNITY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 GREEN ST
WILLIAMSTON NC
27892-2000
US

IV. Provider business mailing address

120 W MARTIN LUTHER KING JR DR
WASHINGTON NC
27889-4906
US

V. Phone/Fax

Practice location:
  • Phone: 252-792-0305
  • Fax:
Mailing address:
  • Phone: 252-644-7003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURENCE J DOBY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-644-7003