Organization
WAKE EMERGENCY PHYSICIANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER RALEY MD (ADMINISTRATOR)
(919) 859-3373
Entity
Organization
Contact information
Practice address
1900 KILDAIRE FARM RD, CARY, NC 27518
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 890053, CHARLOTTE, NC 28289-0053
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0295F
BCBS STATE
NC
01
—
0298N
BLUE CROSS BLUE SHIELD
NC
05
—
890298N
—
NC
01
—
CD5224
RAILROAD MEDICARE
NC
05
—
QPB978
—
SC
Enumeration date
06/10/2006
Last updated
05/24/2018
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