Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 40277 | CA |
NPI | 1023083706 |
---|---|
Provider Name | Dr. Brett Thomas Metcalf |
First Address | Bethesda, MD 20814-1431 |
Second Address | Bethesda, MD 20889-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 08/07/2007 |