DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: NICOLAS MAX FARENWALD DO

MEDICARE: NICOLAS MAX FARENWALD DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramVA
2207QS0010XSports Medicine (Family Medicine) Physician34.017747OH
3207Q00000XFamily Medicine Physician0102208567VA

General Provider Information

NPI Number : 1427636034
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLAS MAX FARENWALD DO
Provider Business Mailing Address
First Line : 1906 BELLEVIEW AVE SE
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1838
Country : US
Telephone Number : 540-981-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1906 BELLEVIEW AVE SE
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1838
Country : US
Telephone Number : 540-981-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 06/03/2026

Similar Medicare Providers

1215955976 — DR. DAVID E JOHNSEN M.D.
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-981-7000
Practice Fax: 540-981-8260
1285883306 — HEATHER D ELEY NP
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-981-7000
Practice Fax: 540-981-8429
1508669045 — BENJAMIN DAVID KNICK DO
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-981-7000
Practice Fax:
1376162529 — BRANDON T NAVE D.O.
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-853-0222
Practice Fax: 540-981-7855
1609317585 — ELENA MARIE KLAUS PA-C
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-981-7000
Practice Fax:
1053315796 — LEE ANN SPEED CRNA
Practice Location Address:
1906 BELLEVIEW AVE SE
ROANOKE, VA
24014-1838
Practice Phone: 540-918-7000
Practice Fax:

Directions to “ NICOLAS MAX FARENWALD DO” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.