Healthcare Provider Details

I. General information

NPI: 1942354717
Provider Name (Legal Business Name): FAITH MEDICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 RICHMOND RD 102
CLEVELAND OH
44143-2792
US

IV. Provider business mailing address

11201 SHAKER BLVD 240
CLEVELAND OH
44104-3869
US

V. Phone/Fax

Practice location:
  • Phone: 216-486-3233
  • Fax: 216-486-3180
Mailing address:
  • Phone: 216-791-0017
  • Fax: 216-791-0021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35050141
License Number StateOH

VIII. Authorized Official

Name: DR. MONA LEE REED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 216-791-0017