Organization
WAKE EAR NOSE AND THROAT SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PANKAJ GUPTA MD (OWNER/CEO)
(919) 943-9287
Entity
Organization
Contact information
Practice address
115 PARKWAY OFFICE CT STE 201, CARY, NC 27518-7431
(919) 851-5636
(919) 851-7247
Mailing address
115 PARKWAY OFFICE CT STE 201, CARY, NC 27518-7431
(919) 851-5636
(919) 851-7247
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023442B
MEDICARE GROUP PTAN
—
Enumeration date
02/15/2010
Last updated
09/05/2024
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