Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 0401007540 | VA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 0438000097 | VA |
NPI | 1265493076 |
---|---|
Provider Name | Dr. Lawrence C Metzger |
First Address | Glen Allen, VA 23059-5666 |
Second Address | Sandston, VA 23150-2345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 02/08/2018 |