Provider Demographics
NPI:1487029294
Name:METTERS, MARLIN
Entity Type:Individual
Prefix:
First Name:MARLIN
Middle Name:
Last Name:METTERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 E MAIN ST
Mailing Address - Street 2:SUITE 018
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7069
Mailing Address - Country:US
Mailing Address - Phone:510-776-3984
Mailing Address - Fax:
Practice Address - Street 1:2025 E MAIN ST
Practice Address - Street 2:SUITE 018
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7069
Practice Address - Country:US
Practice Address - Phone:510-776-3984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator