Provider Demographics
NPI:1265494371
Name:SALEEBY & WESSELS MDS PA
Entity Type:Organization
Organization Name:SALEEBY & WESSELS MDS PA
Other - Org Name:SALEEBY & SALEEBY MDS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALEEBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-787-2542
Mailing Address - Street 1:3814 BROWNING PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7166
Mailing Address - Country:US
Mailing Address - Phone:919-787-2542
Mailing Address - Fax:919-783-8225
Practice Address - Street 1:2406 BLUE RIDGE RD STE 250
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6695
Practice Address - Country:US
Practice Address - Phone:919-787-2542
Practice Address - Fax:919-783-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014TWOtherBCBS NC
NC2344265Medicare ID - Type Unspecified