Individual
DR. GARY L METCALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8050
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2131
(608) 339-6975
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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