Healthcare Provider Details

I. General information

NPI: 1891986535
Provider Name (Legal Business Name): CLYDE C METZGER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHNSON RD SUITE 206
STEUBENVILLE OH
43952-2356
US

IV. Provider business mailing address

PO BOX 994
STEUBENVILLE OH
43952-5994
US

V. Phone/Fax

Practice location:
  • Phone: 740-266-6774
  • Fax: 740-266-6125
Mailing address:
  • Phone: 740-282-2576
  • Fax: 740-282-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35031444M
License Number StateOH

VIII. Authorized Official

Name: CLYDE C METZGER
Title or Position: OWNER
Credential: M.D.
Phone: 740-266-6774