Organization
WAKEFIELD MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN BRIAN SHEARIN (PRESIDENT)
(919) 570-5277
Entity
Organization
Contact information
Practice address
123 CAPCOM AVE STE 3, WAKE FOREST, NC 27587-6517
(919) 570-5277
(919) 570-5377
Mailing address
123 CAPCOM AVE STE 3, WAKE FOREST, NC 27587-6517
(919) 570-5277
(919) 570-5377
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00838
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046XY
BCBSNC
NC
05
—
7703955
—
NC
Enumeration date
09/26/2006
Last updated
08/22/2020
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