Provider Demographics
NPI:1689146250
Name:FAITH INTERNAL MEDICINE PC
Entity type:Organization
Organization Name:FAITH INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-394-7525
Mailing Address - Street 1:PO BOX 767
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-0109
Mailing Address - Country:US
Mailing Address - Phone:205-394-7525
Mailing Address - Fax:205-553-3233
Practice Address - Street 1:755 55TH PL E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4140
Practice Address - Country:US
Practice Address - Phone:205-469-1828
Practice Address - Fax:205-469-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty