Provider Demographics
NPI:1235111527
Name:WAKE HEART AND VASCULAR ASSOCIATES P.A.
Entity Type:Organization
Organization Name:WAKE HEART AND VASCULAR ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-420-1342
Mailing Address - Street 1:700 TILGHMAN DR
Mailing Address - Street 2:728
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5519
Mailing Address - Country:US
Mailing Address - Phone:910-897-7806
Mailing Address - Fax:910-897-6804
Practice Address - Street 1:700 TILGHMAN DR
Practice Address - Street 2:728
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5519
Practice Address - Country:US
Practice Address - Phone:910-897-7806
Practice Address - Fax:910-897-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty