MEDICARE: WAKE AUDIOLOGY & HEARING AID ASSOCIATES, 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	231H00000X	Audiologist	4617	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831286384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAKE AUDIOLOGY & HEARING AID ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	1954 S MAIN ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9336
Country	:	US
Telephone Number	:	919-570-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	1954 S MAIN ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9336
Country	:	US
Telephone Number	:	919-570-8311
Fax Number	:

Authorized Official
Title or Position	:	AUDIOLOGIST /OWNER
Name	:	DR. CATHERINE T MARQUIS
Credential	:	AUD
Telephone Number	:	919-570-8311

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/22/2020

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