Provider Demographics
NPI:1508867417
Name:METROPOLITAN ENT & ALLERGY CENTRE
Entity Type:Organization
Organization Name:METROPOLITAN ENT & ALLERGY CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:VRETZKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-532-7900
Mailing Address - Street 1:2011 FALLS VALLEY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3451
Mailing Address - Country:US
Mailing Address - Phone:919-532-7900
Mailing Address - Fax:919-532-7901
Practice Address - Street 1:2011 FALLS VALLEY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3451
Practice Address - Country:US
Practice Address - Phone:919-532-7900
Practice Address - Fax:919-532-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900716207KA0200X
NC9900706207Y00000X, 207YS0123X
NC3212231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Not Answered207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC134E1OtherBCBS
NC89095NMMedicaid
2342221Medicare ID - Type Unspecified