Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5101020885 | MI |
NPI | 1215349915 |
---|---|
Provider Name | Christopher Michael Metz |
First Address | Madison Heights, MI 48071-5711 |
Second Address | Madison Heights, MI 48071-3487 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2014 |
Last Update Date | 10/06/2019 |