Healthcare Provider Details

I. General information

NPI: 1588717706
Provider Name (Legal Business Name): FAITH MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33001 SOLON RD 203
SOLON OH
44139-2839
US

IV. Provider business mailing address

11201 SHAKER BLVD 204
CLEVELAND OH
44104-3869
US

V. Phone/Fax

Practice location:
  • Phone: 440-519-3869
  • Fax: 440-519-0812
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: 12167910017