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General NPI Number Information
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NPI Number | 1689854812
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Entity Type | Organization
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Legal Business Name | VALLEY RADIOLOGY AT ANGIER LLC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 169 RAWLS RD.
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City | ANGIER
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State | NC
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Zip | 27501
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Country | US
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Telephone | 919-331-2001
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Fax | 919-331-2003
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Provider Business Mailing Address
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Address Line | 169 RAWLS RD.
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City | ANGIER
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State | NC
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Zip | 27501
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Country | US
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Telephone | 919-331-2001
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Fax | 919-331-2003
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAX H FAYKUS
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Credential | MD
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Telephone | 910-486-5700
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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 |
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License Number State | NC
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