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Organization

WAKE EMERGENCY PHYSICIANS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER RALEY MD (ADMINISTRATOR)
(919) 859-3373
Entity
Organization

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 890053, CHARLOTTE, NC 28289-0053
(843) 237-3378
(843) 237-5073

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0295F
BLUE CROSS BLUE SHIELD
NC
05
890295F
NC
01
CD5224
RAILROAD MEDICARE
NC
05
QPA119
SC
Enumeration date
04/19/2006
Last updated
05/24/2018
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