Basic Information
Provider Information
NPI: 1730171133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: METZGER
FirstName: SCOTT
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11350 MCCORMICK ROAD,
Address2: EXECUTIVE PLAZA 1, SUITE 501
City: HUNT VALLEY
State: MD
PostalCode: 21031
CountryCode: US
TelephoneNumber: 4103291071
FaxNumber: 4103291054
Practice Location
Address1: 160 AVENUE AT THE CMN
Address2: SUITE 1
City: SHREWSBURY
State: NJ
PostalCode: 07702
CountryCode: US
TelephoneNumber: 7323800200
FaxNumber: 7323800124
Other Information
ProviderEnumerationDate: 08/22/2005
LastUpdateDate: 05/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900XMA65441NJY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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