Healthcare Provider Details

I. General information

NPI: 1255397105
Provider Name (Legal Business Name): CECILIA AINOLHAYAT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 AVON ST
FAYETTEVILLE NC
28304-4423
US

IV. Provider business mailing address

2112 SKIBO RD
FAYETTEVILLE NC
28314-0233
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-1718
  • Fax:
Mailing address:
  • Phone: 910-764-3232
  • Fax: 910-764-3234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number96-01208
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9601208
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: