MEDICARE: EMILY A METZGER MD

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	207Q00000X	Family Medicine Physician	036150654	IL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	68540	WI

General Provider Information

NPI Number	:	1114381514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY A METZGER MD

Provider Business Mailing Address
First Line	:	7974 UW HEALTH CT
Second Line	:
City	:	MIDDLETON
State	:	WI
Zip	:	53562-5531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4590 COUNTY RD N
Second Line	:
City	:	COTTAGE GROVE
State	:	WI
Zip	:	53527-9208
Country	:	US
Telephone Number	:	608-839-3104
Fax Number	:	608-839-3404

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

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	05/17/2023

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