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General NPI Number Information
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NPI Number | 1982732558
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Entity Type | Individual
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Provider Name | FAIZA RAIS-REYNOLDS MD
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 108 S STATE ST
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City | YADKINVILLE
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State | NC
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Zip | 27055-8249
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Country | US
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Telephone | 336-679-2733
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Fax | 336-679-6263
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | YADKINVILLE
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State | NC
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Zip | 27055-0249
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Country | US
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Telephone | 336-679-4963
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Fax | 336-679-2549
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200901801
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License Number State | NC
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