Organization
VALLEY RADIOLOGY AT ANGIER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX H FAYKUS MD (PRESIDENT)
(910) 486-5700
Entity
Organization
Contact information
Practice address
169 RAWLS RD., ANGIER, NC 27501
(919) 331-2001
(919) 331-2003
Mailing address
169 RAWLS RD., ANGIER, NC 27501
(919) 331-2001
(919) 331-2003
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01572
BCBS
—
01
—
1630307
PHP
NC
01
—
204310
MEDICARE
NC
05
—
8901572
—
NC
01
—
QPA797
SC MEDICAID
NC
Enumeration date
11/05/2007
Last updated
07/21/2022
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