Organization
WAKE EMERGENCY PHYSICIANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RALEY MD (MANAGING PARTNER/ MD)
(919) 859-3373
Entity
Organization
Contact information
Practice address
2460 CURTIS ELLIS DR, ROCKY MOUNT, NC 27804-2237
(252) 962-8000
Mailing address
PO BOX 890053, CHARLOTTE, NC 28289-0053
(855) 691-9890
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0295F
BCBSNC
NC
01
—
2319661A
MEDICARE
NC
Enumeration date
06/27/2019
Last updated
06/27/2019
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