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WAKEMED SPECIALISTS GROUP LLC NPI 1205491487


NPI Information

NPI: 1205491487
Provider Name: WAKEMED SPECIALISTS GROUP LLC

Other Name: WAKEMED UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization
Address:
3024 NEW BERN AVE
RALEIGH, NC
ZIP 27610
Phone: (919) 350-7251
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WAKEMED SPECIALISTS GROUP LLC is an urology in Raleigh, NC. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. WAKEMED SPECIALISTS GROUP LLC NPI is 1205491487. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Wakemed Urology.

The provider's business location address is:

3024 NEW BERN AVE
RALEIGH, NC
ZIP 27610-247
Phone: (919) 350-7251
Fax: (919) 350-1606

The provider's authorized official is Maria Jayoussi .
The authorized official title is Executive Director Of Finance and has the following contact phone number (919) 350-6089.

The enumeration date for this NPI number is 5/3/2019 and was last updated on 8/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11205491487MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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