Healthcare Provider Details

I. General information

NPI: 1619827961
Provider Name (Legal Business Name): LIV SPECIALTY CARE NC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 PARKSIDE MAIN ST
CARY NC
27519-6951
US

IV. Provider business mailing address

4900 CENTENNIAL BLVD STE 300
NASHVILLE TN
37209-1105
US

V. Phone/Fax

Practice location:
  • Phone: 919-301-9426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WOODRUFF HALL BAUM
Title or Position: CEO
Credential:
Phone: 646-568-0193