Provider Demographics
NPI:1316481237
Name:METCALF, ERIC (RN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:METCALF
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 SAMUEL MORSE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3439
Mailing Address - Country:US
Mailing Address - Phone:410-910-6700
Mailing Address - Fax:124-046-5032
Practice Address - Street 1:7055 SAMUEL MORSE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3439
Practice Address - Country:US
Practice Address - Phone:410-910-6700
Practice Address - Fax:124-046-5032
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse