Provider Demographics
NPI:1780797449
Name:HOCHMAN, MARCELO L (MD)
Entity type:Individual
Prefix:MR
First Name:MARCELO
Middle Name:L
Last Name:HOCHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 TECHLENBURG DR
Practice Address - Street 2:SUITE 212 WEST
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29416-5739
Practice Address - Country:US
Practice Address - Phone:843-571-4742
Practice Address - Fax:843-571-3619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC157852086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
57-1078864OtherFED TAX ID #
SC157859 GP 2476Medicaid
SC1471GOtherDEHC
SC15785OtherMEDICAL LICENSE
SC157859 GP 2476Medicaid
F10990Medicare UPIN
SC157859 GP 2476Medicaid