Provider Demographics
NPI:1013997097
Name:METCALF, ROBERT MATHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MATHEW
Last Name:METCALF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 STATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2313
Mailing Address - Country:US
Mailing Address - Phone:704-210-8810
Mailing Address - Fax:704-210-8812
Practice Address - Street 1:205 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2313
Practice Address - Country:US
Practice Address - Phone:704-210-8810
Practice Address - Fax:704-210-8812
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890840PMedicaid