Healthcare Provider Details

I. General information

NPI: 1619840402
Provider Name (Legal Business Name): META DIGITAL DEVELOPERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US

IV. Provider business mailing address

30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 828-298-6718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT HOZEBIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 888-298-6718