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Contact Information

WAKEMED SPECIALISTS GROUP, LLC
3024 NEW BERN AVE
RALEIGH, NC27610-1247
 Phone: 919-350-7856
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Otolaryngology/Facial Plastic Surgery

207YX0905X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for WAKEMED SPECIALISTS GROUP LLC · (Female)

NPI Number 1053976415
Status Active
Credentials
Entity Individual
Enumeration date 05/01/2019
Last updated 05/01/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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