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Contact Information

WAKEMED SPECIALISTS GROUP LLC
3024 NEW BERN AVE
RALEIGH, NC27610-1247
 Phone: 919-350-7331
 Fax: 919-871-1228
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
 

Trauma Surgery

2086S0127X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for WAKEMED SPECIALISTS GROUP LLC

NPI # 1225693419
LBN Legal business name WAKEMED SPECIALISTS GROUP LLC
Authorized official MARIA JAYOUSSI - (EXECUTIVE DIRECTOR OF FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 05/03/2019
Last updated 08/21/2019 - About 7 years ago
Identifiers
NC Medicaid 1225693419
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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