Individual
DR. MELTON R. STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 BLANDING STREET SUITE 2, COLUMBIA, SC 29201
(803) 256-1518
(803) 256-9719
Mailing address
201 SIGMA DR STE 100, SUMMERVILLE, SC 29486-7722
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5408
SC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
5408
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054087
—
SC
Enumeration date
01/31/2006
Last updated
12/09/2019
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