| Wakefield Pediatrics & Adolescent Medicine,p.a. | |
|
14341 New Falls Of Neuse Suite 122 Raleigh NC 27614-8292 | |
| (919) 570-7010 | |
| (919) 570-7020 |
| Full Name | Wakefield Pediatrics & Adolescent Medicine,p.a. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 14341 New Falls Of Neuse, Raleigh, North Carolina |
| Authorized Official Name and Position | Milton-jesus Cabalona Sevilla (PRESIDENT) |
| Authorized Official Contact | 9195707010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wakefield Pediatrics & Adolescent Medicine,p.a. 14341 New Falls Of Neuse Suite 122 Raleigh NC 27614-8292 Ph: (919) 570-7010 | Wakefield Pediatrics & Adolescent Medicine,p.a. 14341 New Falls Of Neuse Suite 122 Raleigh NC 27614-8292 Ph: (919) 570-7010 |
| NPI Number | 1023190915 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023190915 | NPI | - | NPPES |
| 89130T6 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (North Carolina) | Primary |
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