Organization
WAKE SPECIALTY PHYSICIANS, LLC
Active
Other names
Wake Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
120 HEALTHPLEX WAY STE 206, APEX, NC 27502-8403
(919) 232-5020
(919) 232-5021
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942440375
—
NC
Enumeration date
08/31/2018
Last updated
08/31/2018
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