Individual
DR. LYNNE SUSAN WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
204 MEDSPRING DR, CLAYTON, NC 27520-9293
(919) 235-6505
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(877) 498-4490
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
33770
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7873164
AETNA
NC
01
—
88599
BLUE CROSS BLUE SHIELD
NC
05
—
8988599
—
NC
Enumeration date
03/17/2006
Last updated
04/15/2021
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