# WAKE SPECIALTY PHYSICIANS, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** WakeMed ENT Head & Neck Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063823003
- **Authorized official:** MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE)
- **Authorized official phone:** (919) 360-6089

## Contact information

- **Practice address:** 3024 NEW BERN AVE, RALEIGH, NC 27610-1247
- **Practice address phone:** (919) 350-7856
- **Practice address fax:** (919) 350-1635
- **Mailing address:** PO BOX 602195, CHARLOTTE, NC 28260-2195
- **Mailing address phone:** (919) 350-0552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NC | Yes |

## Other

- **Enumeration date:** 05/13/2014
- **Last updated:** 09/12/2016