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NPI Code Detail

MEDICARE: WAKE ORTHOPAEDICS, LLC

MEDICARE: WAKE ORTHOPAEDICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1841243540
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAKE ORTHOPAEDICS, LLC
Provider Business Mailing Address
First Line : 3009 NEW BERN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27610-1214
Country : US
Telephone Number : 919-232-5020
Fax Number : 919-232-5021
Provider Business Practice Location Address
First Line : 3009 NEW BERN AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27610-1214
Country : US
Telephone Number : 919-232-5020
Fax Number : 919-232-5021
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. DAVID A PONTZ
Credential :
Telephone Number : 919-232-5020
Provider Enumeration Date : 05/17/2006
Last Update Date : 08/05/2011

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Directions to “WAKE ORTHOPAEDICS, LLC ” Practice Location

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