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Individual
DR. GARY L METCALF
Active
Individual
DR. GARY L METCALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01065310A
IN
207Q00000X
Family Medicine Physician
Primary
67784-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01065310A
STATE LICENSE
IN
05
—
100070465
—
WI
05
—
200920190
—
IN
01
—
67784-20
STATE LICENSE
WI
Enumeration date
03/23/2007
Last updated
07/21/2022
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