Provider Demographics
NPI:1871669390
Name:THE FACIAL SURGERY CENTER
Entity Type:Organization
Organization Name:THE FACIAL SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-571-4742
Mailing Address - Street 1:526 JOHNNIE DODDS BOULEVARD, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-1703
Mailing Address - Country:US
Mailing Address - Phone:843-571-4742
Mailing Address - Fax:843-571-3619
Practice Address - Street 1:2097 HENRY TECKLENBURG DR
Practice Address - Street 2:SUITE 211 WEST
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5740
Practice Address - Country:US
Practice Address - Phone:843-571-4742
Practice Address - Fax:843-571-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC157859Medicaid
SCF10990Medicare UPIN