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General NPI Number Information
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NPI Number | 1104856145
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Entity Type | Individual
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Provider Name | FRANK M. FAYZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 8201 E RIVERSIDE BLVD
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City | ROCKFORD
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State | IL
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Zip | 61114-2300
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Country | US
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Telephone | 815-971-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 5470 WESSEX CT APT 210
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City | DEARBORN
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State | MI
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Zip | 48126-4270
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Country | US
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Telephone | 313-680-2173
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Fax | 313-584-3000
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 069045
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME117258
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01071636A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD045429E
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35-058853
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301056038
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License Number State | MI
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