Healthcare Provider Details

I. General information

NPI: 1487049565
Provider Name (Legal Business Name): NINA DURCHFORT METCALFE M.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2015
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PEACHTREE ST NW STE 700
ATLANTA GA
30309-2511
US

IV. Provider business mailing address

1551 JANMAR RD
SNELLVILLE GA
30078-5606
US

V. Phone/Fax

Practice location:
  • Phone: 678-344-8900
  • Fax:
Mailing address:
  • Phone: 678-344-8900
  • Fax: 678-691-0506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number83208
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: