Organization
WAKEFIELD PEDIATRICS & ADOLESCENT MEDICINE,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILTON-JESUS CABALONA SEVILLA M.D. (PRESIDENT)
(919) 570-7010
Entity
Organization
Contact information
Practice address
14341 NEW FALLS OF NEUSE, SUITE 122, RALEIGH, NC 27614-8292
(919) 570-7010
(919) 570-7020
Mailing address
14341 NEW FALLS OF NEUSE, SUITE 122, RALEIGH, NC 27614-8292
(919) 570-7010
(919) 570-7020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89130T6
—
NC
Enumeration date
10/19/2006
Last updated
08/22/2020
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