Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 012897 | ME |
N | 207Q00000X | Family Doctor | MD2010-0098 | NM |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD2010-0098 | NM |
N | 207QG0300X | Family Doctor - Geriatric Medicine | RS2009-0379 | NM |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD2010-0098 | NM |
NPI | 1144289851 |
---|---|
Provider Name | Eric W Metzler |
First Address | Albuquerque, NM 87108 |
Second Address | Albuquerque, NM 87108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 11/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011293 | ANTHEM (01) | ME |
121620099 | (05) | ME |
201836 | NGS (01) | ME |
76133737 | (05) | NM |
A58657 | (02) | ME |