Organization
WAKEMED FACULTY PRACTICE PLAN
Active
Parent organization
WAKEMED FACULTY PRACTICE PLAN
Other names
WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKEMED FACULTY PRACTICE PLAN
Authorized official
DR. SUSAN TUCKER WEAVER M.D. (SENIOR VICE PRESIDENT)
(919) 350-8228
Entity
Organization
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-8000
Mailing address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-8000
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
06/21/2011
Last updated
07/05/2011
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