Provider Demographics
NPI:1376524314
Name:METZGER, JONATHAN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:P
Last Name:METZGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:143 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1683
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:
Practice Address - Street 1:5 TARKILN RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-1250
Practice Address - Country:US
Practice Address - Phone:781-585-2200
Practice Address - Fax:781-585-1784
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156683207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA156683OtherTUFTS
MA03179702Medicaid
MA04 2297845OtherTRICARE
MA5972719OtherAETNA
MA04 2297845OtherHCVM
MA0016433OtherNEIGHBORHOOD HLTH PLAN
MA04 2297845OtherDOC FIRST
MA04 2297845OtherPRIVATE HEALTHCARE SYSTEM
MA04 2297845OtherUNITED HEALTH CARE
MA66933OtherHVD PILGRIM HEALTH CARE
MAB10349001OtherCIGNA
MA04 2297845OtherGREAT WEST HEALTH CARE
MA36394OtherFALLON
MAJ18873OtherBCBS
MA04 2297845OtherGIC UNICARE
MAG68056Medicare UPIN
MA04 2297845OtherUNITED HEALTH CARE