Provider Demographics
NPI:1053601252
Name:ANANTH, AMY THERESA METZGER (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:THERESA METZGER
Last Name:ANANTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746984
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6984
Mailing Address - Country:US
Mailing Address - Phone:251-424-1880
Mailing Address - Fax:251-424-1879
Practice Address - Street 1:1851 N MCKENZIE ST STE 104
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4704
Practice Address - Country:US
Practice Address - Phone:251-424-1880
Practice Address - Fax:251-424-1879
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205556207N00000X
AL41753207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology