Provider Demographics
NPI:1306881602
Name:TUBOKU-METZGER, FOLARIN (MD)
Entity type:Individual
Prefix:DR
First Name:FOLARIN
Middle Name:
Last Name:TUBOKU-METZGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2106
Mailing Address - Country:US
Mailing Address - Phone:732-320-9196
Mailing Address - Fax:877-421-3585
Practice Address - Street 1:34 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2106
Practice Address - Country:US
Practice Address - Phone:732-320-9196
Practice Address - Fax:877-421-3585
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07121100207R00000X
NJMA071211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH24460Medicare UPIN