Provider Demographics
NPI:1003965385
Name:BAILONY, FADI (MD)
Entity Type:Individual
Prefix:DR
First Name:FADI
Middle Name:
Last Name:BAILONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7991 BEECHMONT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3191
Mailing Address - Country:US
Mailing Address - Phone:513-528-5600
Mailing Address - Fax:
Practice Address - Street 1:7991 BEECHMONT AVE STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3191
Practice Address - Country:US
Practice Address - Phone:513-528-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37870207R00000X
OH35-080473208M00000X
OH35080473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2378476Medicaid
OHP00884534OtherRR MEDICARE
KY64067614Medicaid
IN200987700Medicaid
OHP00884534OtherRR MEDICARE
OH2378476Medicaid
IN200987700Medicaid