Provider Demographics
NPI:1013914662
Name:METZGER, MONIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
Last Name:METZGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 DANNY THOMAS PL
Mailing Address - Street 2:MS 515
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PL # MS 515
Practice Address - Street 2:C/O DANA CANNON
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN397182080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207235904Medicaid
AL009998465Medicaid
OK200056690AMedicaid
TX177222001Medicaid
IN200520160AMedicaid
MT0147771Medicaid
KS200379210AMedicaid
NC7615330Medicaid
TN5440555Medicaid
KY64099716Medicaid
MS09652249Medicaid
AR158824001Medicaid
LA1777978Medicaid
OK200056690AMedicaid