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1030 Siena Dr Wake Forest NC 27587 | |
| (919) 235-6540 | |
| (919) 235-6504 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1030 Siena Dr, Wake Forest, North Carolina |
| Authorized Official Name and Position | Michael Paul Duffey (EXECUTIVE DIRECTOR FINANCE) |
| Authorized Official Contact | 9193508000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 602195 Charlotte NC 28260-2195 Ph: (919) 350-0552 | 1030 Siena Dr Wake Forest NC 27587 Ph: (919) 235-6540 |
| NPI Number | 1225684004 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 09/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225684004 | NPI | - | NPPES |
| 1225684004 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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