Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2001257 | NM |
NPI | 1114965381 |
---|---|
Provider Name | Andrew K Metzger |
First Address | Albuquerque, NM 87111-1159 |
Second Address | Albuquerque, NM 87111-1159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 03/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H02358 | (02) | NM |
N6965 | (05) | NM |