Provider Demographics
NPI:1073757076
Name:METRO HEALTHCARE PC
Entity Type:Organization
Organization Name:METRO HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-6465
Mailing Address - Street 1:11221 S GLEN RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1847
Mailing Address - Country:US
Mailing Address - Phone:301-345-6465
Mailing Address - Fax:
Practice Address - Street 1:7525 GREENWAY CENTER DR
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3509
Practice Address - Country:US
Practice Address - Phone:301-345-6465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052298207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5287OtherCAREFIRST BLUE CROSS BLUE SHIELD
MD223350900Medicaid
MD5287OtherCAREFIRST BLUE CROSS BLUE SHIELD