Healthcare Provider Details

I. General information

NPI: 1083534549
Provider Name (Legal Business Name): UWH OF THE CAROLINAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 LAKE BOONE TRL STE 309
RALEIGH NC
27607-7521
US

IV. Provider business mailing address

PO BOX 818018
CLEVELAND OH
44181-8018
US

V. Phone/Fax

Practice location:
  • Phone: 919-615-2043
  • Fax:
Mailing address:
  • Phone: 561-300-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY WALKER
Title or Position: ENROLLMENT
Credential:
Phone: 561-300-2410