Provider Demographics
NPI:1720361728
Name:METCALFE, PAUL DEAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DEAN
Last Name:METCALFE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1202
Mailing Address - Country:US
Mailing Address - Phone:219-865-6472
Mailing Address - Fax:219-865-6536
Practice Address - Street 1:22 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1202
Practice Address - Country:US
Practice Address - Phone:219-865-6472
Practice Address - Fax:219-865-6536
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016973A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist