MEDICARE: DR. JOHN WARDELL METCALF M.D.

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	207R00000X	Internal Medicine Physician	MD-040727-L	PA

General Provider Information

NPI Number	:	1255409322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WARDELL METCALF M.D.

Provider Business Mailing Address
First Line	:	190 GEORGE JUNIOR RD
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-4414
Country	:	US
Telephone Number	:	724-458-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 GEORGE JUNIOR RD
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-4414
Country	:	US
Telephone Number	:	724-458-1000
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	03/22/2017

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