Healthcare Provider Details

I. General information

NPI: 1659561876
Provider Name (Legal Business Name): METABOLIC MEDICAL CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 LONG POINT RD SUITE # 100
MT PLEASANT SC
29464-7930
US

IV. Provider business mailing address

570 LONG POINT RD SUITE # 100
MT PLEASANT SC
29464-7930
US

V. Phone/Fax

Practice location:
  • Phone: 843-971-1919
  • Fax: 843-971-1912
Mailing address:
  • Phone: 843-971-1919
  • Fax: 843-971-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number4746
License Number StateSC

VIII. Authorized Official

Name: MR. FRANK DOUGLAS JONES
Title or Position: OWNER
Credential:
Phone: 843-971-1919