Basic Information
| Provider Information | |||||||||
| NPI: | 1912953555 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METZMAN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3024 BUSINESS PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370723132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158516033 | ||||||||
| FaxNumber: | 6158512018 | ||||||||
| Practice Location | |||||||||
| Address1: | 3024 BUSINESS PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370723132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158516033 | ||||||||
| FaxNumber: | 6158512018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 11/30/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD21291 | TN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085N0700X | 21291 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
ID Information
| ID | Type | State | Issuer | Description | 4200977 | 01 | TN | BCBS TN | OTHER | 4076945 | 01 | TN | BCBS | OTHER | 1301440 | 01 | TN | CIGNA | OTHER | 1509291 | 01 | TN | MEDICAID - MTI | OTHER | 1600683 | 01 | TN | UNITED HEALTHCARE OF TN | OTHER | 3058220 | 05 | TN | MEDICAID | 1509291 | 05 | TN | MEDICAID | 300109449 | 01 | TN | RAILROAD MEDICARE | OTHER | 3135887 | 01 | TN | BCBS | OTHER | 3102000 | 01 | TN | BCBS | OTHER | 4291324 | 01 | TN | BCBS - MTI | OTHER | 64911035 | 01 | KY | KY MEDICAID | OTHER |