Provider Demographics
NPI:1912953555
Name:METZMAN, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:METZMAN
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 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:3024 BUSINESS PARK CIR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3132
Practice Address - Country:US
Practice Address - Phone:615-851-6033
Practice Address - Fax:615-851-2018
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD212912085R0202X
TN212912085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4200977OtherBCBS TN
TN4076945OtherBCBS
TN1301440OtherCIGNA
TN1509291OtherMEDICAID - MTI
TN1600683OtherUNITED HEALTHCARE OF TN
TN3058220Medicaid
TN1509291Medicaid
TN300109449OtherRAILROAD MEDICARE
TN3135887OtherBCBS
TN3102000OtherBCBS
TN4291324OtherBCBS - MTI
KY64911035OtherKY MEDICAID
TN3058220Medicaid
TN30582201Medicare PIN
TN103I306937Medicare PIN
TN4291324OtherBCBS - MTI
TN300109449OtherRAILROAD MEDICARE
TN1509291Medicaid