Basic Information
| Provider Information | |||||||||
| NPI: | 1972842839 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WAKE EMERGENCY PHYSICIANS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 890053 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282890053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008157491 | ||||||||
| FaxNumber: | 8432379736 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 COLLEGE ST | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196903000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2013 | ||||||||
| LastUpdateDate: | 05/24/2018 | ||||||||
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| AuthorizedOfficialLastName: | PALOMBARO | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9198593373 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.