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Organization

WAKEMED FACULTY PRACTICE PLAN

Active
Parent organization
WAKEMED FACULTY PRACTICE PLAN
Other names
WakeMed Faculty Physicians-Carolina Cardiology
Organization subpart
Yes

Provider details

NPI number
Legal business name
WAKEMED FACULTY PRACTICE PLAN
Authorized official
DR. SUSAN TUCKER WEAVER MD (SENIOR VICE PRESIDENT)
(919) 350-8228
Entity
Organization

Contact information

Practice address
3324 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 781-7772
(919) 787-6331
Mailing address
3324 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 781-7772
(919) 787-6331

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
12/23/2010
Last updated
12/23/2010
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