MEDICARE: THOMAS S METKUS 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	207RC0000X	Cardiovascular Disease Physician	MD022568E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619947116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS S METKUS M.D.

Provider Business Mailing Address
First Line	:	41 UNIVERSITY DR STE 106
Second Line	:
City	:	NEWTOWN
State	:	PA
Zip	:	18940-1873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 HOLME AVE STE 200
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3004
Country	:	US
Telephone Number	:	215-332-3972
Fax Number	:	215-331-3784

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	05/25/2021

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Directions to “ THOMAS S METKUS M.D.” Practice Location

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