Organization
WAKEMED SPECIALISTS GROUP LLC
Active
Other names
WakeMed Rheumatology
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
10010 FALLS OF NEUSE RD, RALEIGH, NC 27614-8494
(919) 235-6454
(919) 350-9878
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073178398
—
NC
Enumeration date
05/02/2019
Last updated
08/21/2019
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