Healthcare Provider Details

I. General information

NPI: 1699760926
Provider Name (Legal Business Name): WAKE INTERNAL MEDICINE CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8036
US

IV. Provider business mailing address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8010
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-7500
  • Fax: 919-881-9586
Mailing address:
  • Phone: 919-781-7500
  • Fax: 919-881-9586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS MORLEY BROWN
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 919-781-7500