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Organization
WAKEMED SPECIALISTS GROUP, LLC
Active
Organization
WAKEMED SPECIALISTS GROUP, LLC
Active
Other names
WakeMed ENT-Head & Neck Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-7856
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
NULL
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
NULL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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