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Organization

WAKE SPINE AND PAIN SPECIALISTS, PC

Active
Parent organization
WAKE SPINE AND PAIN SPECIALISTS, PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
WAKE SPINE AND PAIN SPECIALISTS, PC
Authorized official
VIJAYSINHA MANDHARE MD (MEDICAL DIRECTOR)
(919) 787-7246
Entity
Organization

Contact information

Practice address
1357 WALTER REED RD STE 101, FAYETTEVILLE, NC 28304-4417
(919) 787-7246
(919) 787-7247
Mailing address
3801 WAKE FOREST RD STE 210, RALEIGH, NC 27609-6864
(919) 787-7246
(919) 787-7246

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Enumeration date
01/12/2021
Last updated
01/19/2021
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