MEDICARE: DR. ROBERT LOUIS FAUL M.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
1	208D00000X	General Practice Physician	01064348A	IN

General Provider Information

NPI Number	:	1205024825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LOUIS FAUL M.D.

Provider Business Mailing Address
First Line	:	6001 WILMER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-5931
Country	:	US
Telephone Number	:	513-385-2241
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 WILMER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-5931
Country	:	US
Telephone Number	:	513-385-2241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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