Healthcare Provider Details

I. General information

NPI: 1881656924
Provider Name (Legal Business Name): FAYETTEVILLE UROLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1786 METROMEDICAL DRIVE
FAYETTEVILLE NC
28304
US

IV. Provider business mailing address

1786 METROMEDICAL DRIVE
FAYETTEVILLE NC
28304
US

V. Phone/Fax

Practice location:
  • Phone: 910-485-8151
  • Fax: 910-485-2963
Mailing address:
  • Phone: 910-485-8151
  • Fax: 910-485-2963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT ALBERT APPEL
Title or Position: PARTNER
Credential: MD
Phone: 910-485-8151