Wake Specialty Physicians, LLC
Pediatrics, Developmental - Behavioral Pediatrics in Raleigh, NC. Organization (NPI-2).
NPI number1659934511
StatusActive
Last updated in NPPESJul 24, 2019
Details
- NPI
- 1659934511
- Entity type
- Organization (NPI-2)
- Legal business name
- Wake Specialty Physicians, LLC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2019
- Last updated
- Jul 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0006X | Pediatrics, Developmental - Behavioral Pediatrics | – | – | Yes |
Other names
- Wakemed Children'S-Pediatric Behavioral Health (Doing Business As)
Practice location
23 Sunnybrook RdRaleigh, NC 27610-1855
Phone 919-350-8797 · Fax 919-350-7859
Mailing address
Po Box 602195Charlotte, NC 28260-2195
Phone 877-498-4490 · Fax 919-350-7687
Authorized official
Maria Jayoussi
Executive Vp Of Finance
9193500554
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