Provider Demographics
NPI:1447350251
Name:METRO, IRENE C (MD)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:C
Last Name:METRO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:851 S MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2086
Mailing Address - Country:US
Mailing Address - Phone:734-451-2272
Mailing Address - Fax:734-451-2554
Practice Address - Street 1:851 S MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2086
Practice Address - Country:US
Practice Address - Phone:734-451-2272
Practice Address - Fax:734-451-2554
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI4301067219207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108242371OtherBLUE CROSS MI
MI1108242371OtherBLUE CROSS MI
MI0N30230Medicare ID - Type Unspecified