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Organization
SOUTHERN WAKE MEDICAL CENTER
Active
Organization
SOUTHERN WAKE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA M YOWELL (OFFICE ADMINISTRATOR)
(919) 557-4319
Entity
Organization
Contact information
Practice address
415 WAKE CHAPEL RD, FUQUAY VARINA, NC 27526-1956
(919) 552-9143
Mailing address
409-415 WAKE CHAPEL RD, FUQUAY VARINA, NC 27526
(919) 552-9143
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02981
GROUP NUMBER BCBSNC
NC
05
—
7902981
—
NC
Enumeration date
12/21/2006
Last updated
08/22/2020
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