MEDICARE: DR. EDOUARD FEGHALI MD

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	207V00000X	Obstetrics & Gynecology Physician	35040477	OH
2	207V00000X	Obstetrics & Gynecology Physician	35-040477	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447255872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDOUARD FEGHALI MD

Provider Business Mailing Address
First Line	:	P O BOX 637407
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-7407
Country	:	US
Telephone Number	:	513-751-5900
Fax Number	:	513-487-4590

Provider Business Practice Location Address
First Line	:	3440 BURNET AVE
Second Line	:	SUITE 120
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2833
Country	:	US
Telephone Number	:	513-751-5900
Fax Number	:	513-487-4590

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	02/17/2012

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