Organization
SUSAN WICKE, MD, PC
Active
Other names
Susan Wicke, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN HOLLY WICKE M.D. (PSYCHIATRIST)
(919) 493-3932
Entity
Organization
Contact information
Practice address
112 SWIFT AVE, DURHAM, NC 27705-4800
(919) 493-3932
(919) 493-3932
Mailing address
112 SWIFT AVENUE, DURHAM, NC 27705
(919) 493-3932
(919) 493-3932
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
36618
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130949
CIGNA BEHAVIORAL HEALTH
NC
01
—
87341
BCBSNC PROVIDER NUMBER
NC
Enumeration date
01/19/2007
Last updated
08/23/2007
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