Provider Demographics
NPI:1376277657
Name:VAN METRE, ANTON (PA-S)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:
Last Name:VAN METRE
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6227 CLUBHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-5427
Mailing Address - Country:US
Mailing Address - Phone:402-470-7141
Mailing Address - Fax:
Practice Address - Street 1:6227 CLUBHOUSE LN
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5427
Practice Address - Country:US
Practice Address - Phone:402-470-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant