WAKEFIELD PEDIATRICS & ADOLESCENT MEDICINEP.A. NPI 1023190915

NPI Information

WAKEFIELD PEDIATRICS & ADOLESCENT MEDICINE,P.A. is a primary care clinic center in Raleigh, NC. WAKEFIELD PEDIATRICS & ADOLESCENT MEDICINE,P.A. NPI is 1023190915. The provider is registered as an organization entity type.

The provider's business location address is:

14341 NEW FALLS OF NEUSE
SUITE 122
RALEIGH, NC
ZIP 27614-292
Phone: (919) 570-7010
Fax: (919) 570-7020

The provider's authorized official is Milton-jesus Cabalona Sevilla .
The authorized official title is President and has the following contact phone number (919) 570-7010.

The CLIA number assigned to this NPI record is 34D0997067 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 8/22/2020.

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:

Other Identifiers

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

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