Provider Demographics
NPI:1083935118
Name:BELLOWS, FARA M (MD)
Entity Type:Individual
Prefix:DR
First Name:FARA
Middle Name:M
Last Name:BELLOWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARA
Other - Middle Name:M
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N PICKAWAY ST STE 402
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1447
Practice Address - Country:US
Practice Address - Phone:740-420-7882
Practice Address - Fax:740-420-8625
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35126913208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0140431Medicaid
OHP01627285OtherRAILROAD MEDICARE
OHP01627285OtherRAILROAD MEDICARE