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NPI Code Detail

MEDICARE: MARY BETH FAIS AU.D

MEDICARE: MARY BETH FAIS AU.D
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
1231H00000XAudiologist0224OH

General Provider Information

NPI Number : 1033380621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BETH FAIS AU.D
Provider Business Mailing Address
First Line : 974 BETHEL RD
Second Line : SUITE A
City : COLUMBUS
State : OH
Zip : 43214-2467
Country : US
Telephone Number : 614-538-2424
Fax Number : 614-538-2418
Provider Business Practice Location Address
First Line : 1810 MACKENZIE DR
Second Line : 2ND FLOOR
City : COLUMBUS
State : OH
Zip : 43220-2967
Country : US
Telephone Number : 614-273-2250
Fax Number : 614-273-2255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2008
Last Update Date : 03/21/2008

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