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Contact Information

WAKE SPECIALTY PHYSICIANS, LLC
23 SUNNYBROOK RD
RALEIGH, NC27610-1855
 Phone: 919-235-6422
 Fax: 919-231-0314
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for WAKE SPECIALTY PHYSICIANS LLC · (Female)

NPI # 1861922775
Status Active
Credentials
Entity Individual
Enumeration date 06/13/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC Medicaid 1942440375
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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