Provider Demographics
NPI:1720081128
Name:METCALF, VERN ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:VERN
Middle Name:ARTHUR
Last Name:METCALF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 S CROATAN HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8504
Mailing Address - Country:US
Mailing Address - Phone:252-449-7373
Mailing Address - Fax:252-449-7371
Practice Address - Street 1:4810 S CROATAN HWY
Practice Address - Street 2:STE 100
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8504
Practice Address - Country:US
Practice Address - Phone:252-449-7373
Practice Address - Fax:252-449-7371
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891243RMedicaid
H01455Medicare UPIN
NC891243RMedicaid