MEDICARE: EMMA METZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	99105554A	IN

General Provider Information

NPI Number	:	1982379665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA METZ

Provider Business Mailing Address
First Line	:	9320 OTIS AVENUE
Second Line	:	APT. 2411
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46216-2325
Country	:	US
Telephone Number	:	417-360-0433
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 W WALNUT ST # IB-130
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5181
Country	:	US
Telephone Number	:	417-360-0433
Fax Number	:	317-968-1354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	08/13/2021

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Directions to “ EMMA METZ ” Practice Location

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