Provider Demographics
NPI:1114515491
Name:MESSER, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:MESSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 N STAR RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2961
Mailing Address - Country:US
Mailing Address - Phone:614-256-5006
Mailing Address - Fax:
Practice Address - Street 1:3880 JACKPOT RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7500
Practice Address - Country:US
Practice Address - Phone:614-594-3988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)