MEDICARE: NORTH WAKE CARDIOVASCULAR CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	D0075445	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2279698	OTHER		PTAN

General Provider Information

NPI Number	:	1225426950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH WAKE CARDIOVASCULAR CENTER PLLC

Provider Business Mailing Address
First Line	:	3903 BRIAR KNOLL CIR
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-2132
Country	:	US
Telephone Number	:	410-593-7015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3903 BRIAR KNOLL CIR
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-2132
Country	:	US
Telephone Number	:	410-593-7015
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. JACK NEWMAN
Credential	:	MD
Telephone Number	:	410-593-7015

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	04/13/2015

Similar Medicare Providers

1215915012 — DR. JACK NATHANIEL NEWMAN JR. M.D.
Practice Location Address:

3903 BRIAR KNOLL CIR
PHOENIX, MD
21131-2132

Practice Phone: 919-630-1616
Practice Fax:

1043402498 — MS. LAURIE MATTHEWS I
Practice Location Address:

2132 W HASAN DR
PHOENIX, AZ
85041-5310

Practice Phone: 602-305-9180
Practice Fax:

1912166620 — DR. MICHAEL DENICOLE DO
Practice Location Address:

2132 E NORTHVIEW AVE
PHOENIX, AZ
85020-5661

Practice Phone: 602-615-8207
Practice Fax:

1982336194 — LINDA M SERONEI ADMINISTRATOR
Practice Location Address:

2132 E KINGS AVE
PHOENIX, AZ
85022-2900

Practice Phone: 602-218-6562
Practice Fax:

1255064465 — KINANLLC
Practice Location Address:

2132 E KINGS AVE
PHOENIX, AZ
85022-2900

Practice Phone: 602-218-6562
Practice Fax:

1023099223 — DR. BARRY M WEINER O.D.
Practice Location Address:

3421 SWEET AIR RD
PHOENIX, MD
21131-1812

Practice Phone: 410-628-1510
Practice Fax: 410-666-5244

Directions to “NORTH WAKE CARDIOVASCULAR CENTER PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.