# SUSAN WICKE, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Susan Wicke, MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629121223
- **Authorized official:** DR. SUSAN HOLLY WICKE M.D. (PSYCHIATRIST)
- **Authorized official phone:** (919) 493-3932

## Contact information

- **Practice address:** 112 SWIFT AVE, DURHAM, NC 27705-4800
- **Practice address phone:** (919) 493-3932
- **Practice address fax:** (919) 493-3932
- **Mailing address:** 112 SWIFT AVENUE, DURHAM, NC 27705
- **Mailing address phone:** (919) 493-3932
- **Mailing address fax:** (919) 493-3932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 36618 | NC | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 08/23/2007