Provider Demographics
NPI:1326020611
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 1:1031 W WILLIAMS ST
Mailing Address - Street 2:105-B
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3955
Mailing Address - Country:US
Mailing Address - Phone:919-387-4120
Mailing Address - Fax:919-387-4148
Practice Address - Street 1:1031 W WILLIAMS ST
Practice Address - Street 2:105-B
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3955
Practice Address - Country:US
Practice Address - Phone:919-387-4120
Practice Address - Fax:919-387-4148
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