Organization Name: | WANEK MEDICAL CENTER PLLC |
NPI Number: | 1417261116 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH A WANEK (OWNER) |
Mailing Address: | 6 N Pointe Ct Greensboro |
State: | NC US |
Postal Code: | 274083187 |
Phone Number: | 3365451020 |
Fax Number: | 3365456090 |
NPI Enumeration Date: | 08/05/2010 |
NPI Last Update Date: | 01/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 38235 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |