Healthcare Provider Details

I. General information

NPI: 1689854812
Provider Name (Legal Business Name): VALLEY RADIOLOGY AT ANGIER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RAWLS RD.
ANGIER NC
27501
US

IV. Provider business mailing address

169 RAWLS RD.
ANGIER NC
27501
US

V. Phone/Fax

Practice location:
  • Phone: 919-331-2001
  • Fax: 919-331-2003
Mailing address:
  • Phone: 919-331-2001
  • Fax: 919-331-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. MAX H FAYKUS
Title or Position: PRESIDENT
Credential: MD
Phone: 910-486-5700