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Organization

WAKEMED

Active
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Organization

WAKEMED

Active
Other names
WakeMed Professional Physicians Staff
Organization subpart
No

Provider details

NPI number
Authorized official
MS. REBECCA E. ANDREWS (VP, FINANCE)
(919) 350-8344
Entity
Organization

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
(919) 350-0559
Mailing address
3000 NEW BERN AVE, MANAGED CARE CONTRACTING DEPT., RALEIGH, NC 27610-1231
(919) 350-0558
(919) 350-0559

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
207ZC0500X
Cytopathology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
208000000X
Pediatrics Physician
208600000X
Surgery Physician
208M00000X
Hospitalist Physician
282N00000X
General Acute Care Hospital
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194907717
NC
05
890770G
NC
Enumeration date
12/05/2007
Last updated
01/23/2017
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