Provider Demographics
NPI:1164277307
Name:APEX METABOLIC, LLC
Entity type:Organization
Organization Name:APEX METABOLIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL GOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-445-7468
Mailing Address - Street 1:4000 LEAP RD
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-0070
Mailing Address - Country:US
Mailing Address - Phone:614-363-0847
Mailing Address - Fax:614-363-1388
Practice Address - Street 1:1151 BETHEL RD STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2775
Practice Address - Country:US
Practice Address - Phone:614-363-0847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty