Organization
WAKEMED SPECIALISTS GROUP LLC
Active
Other names
WakeMed Plastic & Reconstructive Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDRA LYNN BRINK (VP, WPP)
(919) 350-6045
Entity
Organization
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-7331
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0554
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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