Healthcare Provider Details

I. General information

NPI: 1316216393
Provider Name (Legal Business Name): METRO PROSTHETICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 FITCH AVE
NOTTINGHAM MD
21236-3716
US

IV. Provider business mailing address

7438 ANNAPOLIS RD
LANDOVER HILLS MD
20784-2314
US

V. Phone/Fax

Practice location:
  • Phone: 410-870-0365
  • Fax: 410-870-0494
Mailing address:
  • Phone: 301-459-0999
  • Fax: 301-731-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER GOLLER
Title or Position: PRESIDENT
Credential: CP
Phone: 301-459-0999