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Organization
WAKE SPECIALTY PHYSICIANS
Active
Organization
WAKE SPECIALTY PHYSICIANS
Active
Parent organization
WAKE SPECIALTY PHYSICIANS
Other names
WSP WELLNESS FAMILY PRACTICE
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
100 RIDGE VIEW DR, SUITE 105, CARY, NC 27511-5589
(919) 859-7044
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
08/01/2012
Last updated
08/01/2012
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