Organization
WESTERN WAKE SURGICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA L DAVIS (BILLING ADMINISTRATOR)
(919) 859-4747
Entity
Organization
Contact information
Practice address
155 PARKWAY OFFICE CT, SUITE 101, CARY, NC 27518-7427
(919) 859-4747
(919) 859-4757
Mailing address
155 PARKWAY OFFICE CT, SUITE 101, CARY, NC 27518-7427
(919) 859-4747
(919) 859-4757
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
73992
NC
208C00000X
Colon & Rectal Surgery Physician
73992
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295Y
BCBS
NC
05
—
891295Y
—
NC
Enumeration date
02/27/2008
Last updated
09/16/2011
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