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Organization
WAKE SPECIALTY PHYSICIANS, LLC
Active
Organization
WAKE SPECIALTY PHYSICIANS, LLC
Active
Other names
WakeMed Maternal Fetal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-6002
(919) 350-6003
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0552
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
05/13/2014
Last updated
09/12/2016
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