MEDICARE: FAITH FAMILY HEALTH

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1346345352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITH FAMILY HEALTH

Provider Business Mailing Address
First Line	:	6096 E MAIN ST
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	OH
Zip	:	43213-4302
Country	:	US
Telephone Number	:	614-577-0400
Fax Number	:	614-577-0040

Provider Business Practice Location Address
First Line	:	6096 E MAIN ST
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	OH
Zip	:	43213-4302
Country	:	US
Telephone Number	:	614-577-0400
Fax Number	:	614-577-0040

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	BERNADETTE ANDERSON
Credential	:	M.D.
Telephone Number	:	614-577-0400

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/16/2010

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Directions to “FAITH FAMILY HEALTH ” Practice Location

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