Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 31317 | KY |
NPI | 1063430171 |
---|---|
Provider Name | Daniel Stewart Metzinger |
First Address | Louisville, KY 40202-1622 |
Second Address | Louisville, KY 40202-3229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 30/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000007338Z | HUMANA PSC (01) | |
000021037N | HUMANA FOUNDATION (01) | |
200336380 | (05) | IN |
64034218 | (05) | KY |
G86104 | (02) | KY |