Provider Demographics
NPI:1689912792
Name:METRO INTERNAL MEDICINE P.A.
Entity Type:Organization
Organization Name:METRO INTERNAL MEDICINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-877-1100
Mailing Address - Street 1:3320 EXECUTIVE DR
Mailing Address - Street 2:STE. 222
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7445
Mailing Address - Country:US
Mailing Address - Phone:919-877-1100
Mailing Address - Fax:919-877-8118
Practice Address - Street 1:3320 EXECUTIVE DR
Practice Address - Street 2:STE. 222
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7445
Practice Address - Country:US
Practice Address - Phone:919-877-1100
Practice Address - Fax:919-877-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901643261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care