Provider Demographics
NPI:1912964362
Name:METZ, KARL V (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:V
Last Name:METZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23285
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-0285
Mailing Address - Country:US
Mailing Address - Phone:440-543-1130
Mailing Address - Fax:440-543-0833
Practice Address - Street 1:5192 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4196
Practice Address - Country:US
Practice Address - Phone:440-543-1130
Practice Address - Fax:440-543-0833
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH35-06-2019-M207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0848202Medicaid
OH0706222Medicare ID - Type Unspecified
OHC35626Medicare UPIN