Provider Demographics
NPI:1275564957
Name:METZGER, M DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:M
Middle Name:DIANA
Last Name:METZGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 BALDWIN LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3502
Mailing Address - Country:US
Mailing Address - Phone:302-762-5927
Mailing Address - Fax:302-731-7100
Practice Address - Street 1:604 BALDWIN LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3502
Practice Address - Country:US
Practice Address - Phone:302-762-5927
Practice Address - Fax:302-731-7100
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine