Organization
WAKE SPECIALTY PHYSICIANS LLC
Active
Other names
WakeMed Rheumatology
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR, FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
10010 FALLS OF NEUSE RD, RALEIGH, NC 27614-8494
(919) 235-6450
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0554
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942440375
—
NC
Enumeration date
06/09/2016
Last updated
09/12/2016
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