| Wake Specialty Physicians, Llc | |
|
10010 Falls Of Neuse Rd Raleigh NC 27614-8494 | |
| (919) 848-9451 | |
| (919) 848-9758 |
| Full Name | Wake Specialty Physicians, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10010 Falls Of Neuse Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Maria Jayoussi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9193506089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wake Specialty Physicians, Llc Po Box 602195 Charlotte NC 28260-2195 Ph: (919) 350-0554 | Wake Specialty Physicians, Llc 10010 Falls Of Neuse Rd Raleigh NC 27614-8494 Ph: (919) 848-9451 |
| NPI Number | 1316358252 |
|---|---|
| Provider Enumeration Date | 05/14/2014 |
| Last Update Date | 09/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316358252 | NPI | - | NPPES |
| 1942440375 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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