MEDICARE: MARK METRY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	34.018086	OH
2	390200000X	Student in an Organized Health Care Education/Training Program		OH

General Provider Information

NPI Number	:	1619504263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK METRY DO

Provider Business Mailing Address
First Line	:	3035 HAMILTON MASON RD STE 201
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-5545
Country	:	US
Telephone Number	:	513-246-1900
Fax Number	:	513-852-1794

Provider Business Practice Location Address
First Line	:	3035 HAMILTON MASON RD STE 201
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-5545
Country	:	US
Telephone Number	:	513-246-1900
Fax Number	:	513-852-1794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	11/20/2025

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Directions to “ MARK METRY DO” Practice Location

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