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WAKE SPECIALTY PHYSICIANS LLC NPI 1336550375


NPI Information

NPI: 1336550375
Provider Name: WAKE SPECIALTY PHYSICIANS, LLC

Doing Business As: WAKEMED MATERNAL FETAL MEDICINE

Classification: Obstetrics & Gynecology - 207VM0101X
Entity Type: Organization

Specialization: Maternal & Fetal Medicine

CLIA Number: 34D2130284

Address:
3024 NEW BERN AVE
RALEIGH, NC
ZIP 27610
Phone: (919) 350-6002
Get Directions

WAKE SPECIALTY PHYSICIANS, LLC is a maternal and fetal medicine obstetrics gynecology in Raleigh, NC. The provider is an obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. WAKE SPECIALTY PHYSICIANS, LLC NPI is 1336550375. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wakemed Maternal Fetal Medicine.

The provider's business location address is:

3024 NEW BERN AVE
RALEIGH, NC
ZIP 27610-247
Phone: (919) 350-6002
Fax: (919) 350-6003

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

The CLIA number assigned to this NPI record is 34D2130284 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/13/2014 and was last updated on 9/12/2016.


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
1207VM0101XObstetrics & GynecologyMaternal & Fetal MedicineYes

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
11942440375MEDICAIDNORTH CAROLINA
22347332MEDICARE PINNORTH 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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