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Organization
WAKE SPECIALTY PHYSICIANS
Active
Organization
WAKE SPECIALTY PHYSICIANS
Active
Parent organization
WAKE SPECIALTY PHYSICIANS
Other names
WSP MORRISVILLE PRIMARY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE SPECIALTY PHYSICIANS
Authorized official
DR. SUSAN TUCKER WEAVER MD (EXECUTIVE VICE PRESIDENT)
(919) 350-8228
Entity
Organization
Contact information
Practice address
6102 GRACE PARK DR, MORRISVILLE, NC 27560-6003
(919) 235-6405
Mailing address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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