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Contact Information

WAKE SPECIALTY PHYSICIANS, LLC
23 SUNNYBROOK RD
RALEIGH, NC27610-1855
 Phone: 919-350-8797
 Fax: 919-350-7859
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for WAKE SPECIALTY PHYSICIANS, LLC

NPI # 1467863480
LBN Legal business name WAKE SPECIALTY PHYSICIANS, LLC
Authorized official MARIA JAYOUSSI - (EXECUTIVE DIRECTOR)
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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