Provider Demographics
NPI:1619504263
Name:METRY, MARK (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:METRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 HAMILTON MASON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5545
Mailing Address - Country:US
Mailing Address - Phone:513-246-1900
Mailing Address - Fax:513-852-1794
Practice Address - Street 1:3035 HAMILTON MASON RD STE 201
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-5545
Practice Address - Country:US
Practice Address - Phone:513-246-1900
Practice Address - Fax:513-852-1794
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.018086207RE0101X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program