Organization
WAKE SPECIALTY PHYSICIANS, LLC
Active
Parent organization
WAKE SPECIALTY PHYSICIANS, LLC
Other names
WakeMed Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAKE SPECIALTY PHYSICIANS, LLC
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR)
(919) 350-6089
Entity
Organization
Contact information
Practice address
212 ASHVILLE AVE, SUITE 10, CARY, NC 27518-6669
(919) 859-1136
(919) 859-4240
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013297365
—
NC
Enumeration date
08/18/2011
Last updated
09/14/2015
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