NPI 1053976415

Wakemed Specialists Group, LLC

Organisation Otolaryngology Physician Raleigh, NC

Practice location

Address: 3024 New Bern Ave, Raleigh, NC 27610-1247
Phone: (919) 350-7856
Mailing address: 2920 Highwoods Blvd, Raleigh, NC 27604-0010

Authorised official

Name: Maria Jayoussi
Title: Executive Director of Finance
Phone: (919) 350-6089

Registered specialties (3)

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X

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Plastic Surgery within the Head & Neck (Otolaryngology) Physician

Allopathic & Osteopathic Physicians Taxonomy 207YX0007X

Otolaryngology/Facial Plastic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207YX0905X

Registry record

NPI: 1053976415
Entity type: Organization
NPI issued: 1 May 2019
Record last updated: 1 May 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.