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Organization

WAKE SPECIALTY PHYSICIANS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR)
(919) 350-6089
Entity
Organization

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8228
(919) 350-7976
Mailing address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8228
(919) 350-7976

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
208000000X
Pediatrics Physician
208600000X
Surgery Physician
Primary
208800000X
Urology Physician
225100000X
Physical Therapist
225X00000X
Occupational Therapist
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
02/25/2009
Last updated
04/22/2019
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