Basic Information
Provider Information
NPI: 1790731065
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: METZGER
FirstName: DONALD
MiddleName: E
NamePrefix: MR.
NameSuffix: II
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2002 N CEDAR ST STE B
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283583926
CountryCode: US
TelephoneNumber: 9102723048
FaxNumber: 9107383764
Practice Location
Address1: 300 W 27TH ST
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283583075
CountryCode: US
TelephoneNumber: 9106715000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 11/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X104134NCY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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