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Contact Information

WAKE SPECIALTY PHYSICIANS, LLC
3024 NEW BERN AVE
RALEIGH, NC27610-1247
 Phone: 919-350-6002
 Fax: 919-350-6003
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for WAKE SPECIALTY PHYSICIANS, LLC

NPI # 1336550375
LBN Legal business name WAKE SPECIALTY PHYSICIANS, LLC
Authorized official MARIA JAYOUSSI - (EXECUTIVE DIRECTOR FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 05/13/2014
Last updated 09/12/2016 - About 10 years ago
Identifiers
NC Medicaid 1942440375
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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