Healthcare Provider Details

I. General information

NPI: 1124965926
Provider Name (Legal Business Name): MEDICAL MANAGEMENT PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6925 SC-707 SUITE A
MYRTLE BEACH SC
29588-7310
US

IV. Provider business mailing address

6925 SC-707 SUITE A
MYRTLE BEACH SC
29588-7310
US

V. Phone/Fax

Practice location:
  • Phone: 843-233-9609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON MARUCCI
Title or Position: MGMR
Credential: DC
Phone: 561-222-8208