Organization
WOUND CARE PHYSICIANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES E FOGARTIE JR. VASCULAR SURGEON (MEDICAL DIRECTOR)
(919) 784-2584
Entity
Organization
Contact information
Practice address
2916 BLUE RIDGE RD, RALEIGH, NC 27612-7505
(919) 784-2580
(919) 784-2581
Mailing address
4420 LAKE BOONE TRAIL, RALEIGH, NC 27607-7505
(919) 532-2144
(919) 532-2145
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
139456
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018VJ
BCBSNC
NC
05
—
5905840
—
NC
Enumeration date
06/11/2007
Last updated
05/22/2008
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