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Organization
WAKEMED SPECIALISTS GROUP LLC
Active
Organization
WAKEMED SPECIALISTS GROUP LLC
Active
Other names
WakeMed Obstetrics & Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN REVICKI PERRY (SLED)
(919) 350-8000
Entity
Organization
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-1380
(919) 556-0124
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
—
NULL
207VX0000X
Obstetrics Physician
—
—
Other
Enumeration date
05/01/2019
Last updated
07/23/2025
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