Provider Demographics
NPI:1285443788
Name:METACEL WOUND PHYSICIANS PC
Entity type:Organization
Organization Name:METACEL WOUND PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-667-2902
Mailing Address - Street 1:801 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4726
Mailing Address - Country:US
Mailing Address - Phone:440-667-2902
Mailing Address - Fax:
Practice Address - Street 1:801 W BIG BEAVER RD STE 300-006
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4726
Practice Address - Country:US
Practice Address - Phone:440-667-2902
Practice Address - Fax:248-928-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty