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General NPI Number Information
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NPI Number | 1396791786
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Entity Type | Organization
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Legal Business Name | WAKEMED FACULTY PRACTICE PLAN
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 3024 NEW BERN AVE SUITE 300
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City | RALEIGH
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State | NC
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Zip | 27610-1247
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Country | US
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Telephone | 919-350-8228
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Fax | 919-350-7976
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Provider Business Mailing Address
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Address Line | 3024 NEW BERN AVE SUITE 300
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City | RALEIGH
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State | NC
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Zip | 27610-1247
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Country | US
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Telephone | 919-350-8228
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Fax | 919-350-7976
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Authorized Official
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Title or Position | VP, WAKEMED FACULTY PHYSICIANS
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Name | DR. MICHAEL I CINOMAN
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Credential | M.D.
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Telephone | 919-350-8228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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