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Organization
WAYNE HEART & INTERNAL MEDICINE ASSOCIATES PA
Active
Organization
WAYNE HEART & INTERNAL MEDICINE ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAGMOHAN D GUPTA M.D. (PRESIDENT)
(919) 736-4724
Entity
Organization
Contact information
Practice address
2704 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9460
(919) 736-4724
(919) 736-4721
Mailing address
2704 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9460
(919) 736-4724
(919) 736-4721
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02912
BCBS
NC
05
—
8902912
—
NC
Enumeration date
07/13/2006
Last updated
04/15/2015
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