Organization
WAKEMED SPECIALISTS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
(919) 350-7687
Mailing address
3024 NEW BERN AVE FL 3, RALEIGH, NC 27610-1247
(919) 350-0985
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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