Provider Demographics
NPI:1033134374
Name:METZGER, TODD L (OD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:L
Last Name:METZGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:1702 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-364-3300
Practice Address - Fax:701-364-8906
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND541152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND200104OtherLHS #
ND15682OtherNDBS #
ND2201200OtherMEDICA #
ND2201201OtherMEDICA #
ND880541OtherND VISION #
ND162224200Medicaid
ND59D22MEOtherMNBS #
ND60483Medicaid
NDHP25716OtherHEALTHPARTNERS #
ND142963OtherUCARE #
ND2201509OtherMEDICA #
NDDA9011026982OtherPREFERRED ONE #
ND52Q77MEOtherMNBS #
ND890541OtherND VISION #
ND905897OtherAMERICA'S PPO/ARAZ #
ND905897OtherAMERICA'S PPO/ARAZ #
NDDA9011026982OtherPREFERRED ONE #
ND2201201OtherMEDICA #
ND59D22MEOtherMNBS #
ND890541OtherND VISION #