Organization
WAKE TEEN MEDICAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOYCE WOOD (PRESIDENT, EXECUTIVE DIRECTOR)
(919) 828-0038
Entity
Organization
Contact information
Practice address
505 OBERLIN RD, SUITE 204, RALEIGH, NC 27605-1397
(909) 828-0035
(909) 828-0355
Mailing address
505 OBERLIN RD, SUITE 204, RALEIGH, NC 27605-1397
(909) 828-0035
(909) 828-0355
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02730
NC BCBS GROUP NUMBER
NC
05
—
8902730
—
NC
Enumeration date
05/01/2006
Last updated
08/22/2020
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