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General NPI Number Information
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NPI Number | 1487883278
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Entity Type | Organization
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Legal Business Name | WAKE HEART AND VASCULAR ASSOCIATES PA
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 6905 KNIGHTDALE BLVD 103
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City | KNIGHTDALE
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State | NC
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Zip | 27545-6505
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Country | US
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Telephone | 919-573-1220
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Fax | 919-573-1215
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Provider Business Mailing Address
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Address Line | 6905 KNIGHTDALE BLVD 103
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City | KNIGHTDALE
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State | NC
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Zip | 27545-6505
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Country | US
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Telephone | 919-573-1220
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Fax | 919-573-1215
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DEE DARKES
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Credential |
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Telephone | 919-420-1342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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