Healthcare Provider Details

I. General information

NPI: 1477782969
Provider Name (Legal Business Name): MAXIMILIAN PYKO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 GRANDVIEW PKWY STE 100
BIRMINGHAM AL
35243-2065
US

IV. Provider business mailing address

3570 GRANDVIEW PKWY STE 100
BIRMINGHAM AL
35243-2065
US

V. Phone/Fax

Practice location:
  • Phone: 205-905-8411
  • Fax: 205-460-8560
Mailing address:
  • Phone: 205-905-8411
  • Fax: 205-460-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number02004913A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberOS21819
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberDO.1508
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: