Healthcare Provider Details

I. General information

NPI: 1104895051
Provider Name (Legal Business Name): MICHAEL HERMAN METZLER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE SUITE 2200
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

2500 ROCKY MOUNTAIN AVE SUITE 2200
LOVELAND CO
80538-9004
US

V. Phone/Fax

Practice location:
  • Phone: 970-203-7000
  • Fax: 970-203-7055
Mailing address:
  • Phone: 970-203-7000
  • Fax: 970-203-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberDR.0051220
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0051220
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: