Organization
WAKEMED SPECIALISTS GROUP, LLC
Active
Other names
WakeMed Wake Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
400 US HIGHWAY 70 E, STE 100, GARNER, NC 27529-4850
(919) 232-5020
(919) 232-5021
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/06/2019
Last updated
08/28/2019
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