Personalized Hematology-oncology Of Wake Forest Pllc | |
11635 North Park Drive Wake Forest NC 27587-6298 | |
(919) 556-2907 | |
(919) 435-1060 |
Full Name | Personalized Hematology-oncology Of Wake Forest Pllc |
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Speciality | Internal Medicine |
Location | 11635 North Park Drive, Wake Forest, North Carolina |
Authorized Official Name and Position | Luminita Castillos (PRACTICE MANAGER) |
Authorized Official Contact | 9195562907 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Personalized Hematology-oncology Of Wake Forest Pllc 11635 North Park Drive Suite 250 Wake Forest NC 27587-6298 Ph: (919) 825-4637 | Personalized Hematology-oncology Of Wake Forest Pllc 11635 North Park Drive Wake Forest NC 27587-6298 Ph: (919) 556-2907 |
NPI Number | 1053679944 |
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Provider Enumeration Date | 04/27/2012 |
Last Update Date | 07/05/2012 |
Medicare PECOS PAC ID | 4284899121 |
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Medicare Enrollment ID | O20120627000644 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053679944 | NPI | - | NPPES |
89137UC | Medicaid | NC | |
137UC | Other | NC | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 200400833 (North Carolina) | Secondary |
207RH0003X | Internal Medicine - Hematology & Oncology | 200400833 (North Carolina) | Primary |
Provider Name | Francisco A Castillos |
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Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1619978285 PECOS PAC ID: 4284603200 Enrollment ID: I20040927001138 |
Provider Name | Paul Vansweden |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932428885 PECOS PAC ID: 2961620067 Enrollment ID: I20140903001145 |
Provider Name | Em Toe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609648997 PECOS PAC ID: 3779920350 Enrollment ID: I20240318003772 |
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