PERSONALIZED HEMATOLOGY-ONCOLOGY OF WAKE FOREST PLLC (NPI# 1053679944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053679944 |
| Entity Type | Organization |
| Organization Name | PERSONALIZED HEMATOLOGY-ONCOLOGY OF WAKE FOREST PLLC |
| Practice Address |
11635 North Park Drive Wake Forest NC 27587-6298 |
| Mailing Address |
11635 North Park Drive Suite 250 Wake Forest NC 27587-6298 |
| Practice Telephone | 9195562907 |
| Practice Fax Number | 9194351060 |
| Mailing Telephone | 9198254637 |
| Mailing Fax Number | 9194351060 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-07-05 |
| Authorized Official Name | MRS. LUMINITA CASTILLOS (PRACTICE MANAGER) |
| Authorized Official Telephone | 9195562907 |
| Authorized Official Credential | PHD, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 200400833 | NC | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
200400833 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 137UC | 01 |
| NC | 89137UC | 05 |
| Street Address |
11635 NORTH PARK DRIVE |
| City | WAKE FOREST |
| State | NC |
| Zip Code | 27587-6298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275561847 | Duke University Affiliated Physicians, Inc. | Family Medicine | 11635 North Park Drive, Wake Forest, NC 27587-6526 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713080 | Catherine Restrepo | Speech-Language Pathologist | 900 S Franklin St, Ste 201, Wake Forest, NC 27587 | 2020-06-03 |
| 1942760277 | Samantha Fae Pugh | Occupational Therapist | 200 Dr. Calvin Jones Hwy, Suite 200, Wake Forest, NC 27587 | 2019-03-22 |
| 1851863609 | The Counseling Collective | Counselor | 1764 Heritage Center Drive, 204, Wake Forest, NC 27587 | 2018-12-18 |
| 1891270856 | Halston Hoke | Speech-Language Pathologist | 620 Dr. Calvin Jones Hwy Ste 200, Wake Forest, NC 27587 | 2018-09-26 |
| 1710465620 | Amy K Tarnowski | Physical Therapist | The Lodge At Wake Forest, 1151 South Main Street, Wake Forest, NC 27587 | 2018-08-02 |
| 1518452341 | Language and Literacy 365, Pllc | Speech-Language Pathologist | 956 Templeridge Rd, Wake Forest, NC 27587 | 2018-06-25 |
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1124544499 | Carolina Concussion & Physical Medicine, Pllc | Chiropractor | 120 Capcom Aveune, Suite 104, Wake Forest, NC 27587 | 2017-08-18 |
| 1902293889 | Katherine Armine Lorch | Student in an Organized Health Care Education/Training Program | 3000 Rogers Road Ste 210, Wake Forest, NC 27587 | 2015-04-18 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| Find all providers in zip 27587 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619978285 | Francisco A Castillos | Internal Medicine | 11635 Northpark Dr, Suite 250, Wake Forest, NC 27587-6526 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851909816 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 660, Charlotte, NC 28204-3215 | 2020-07-16 |
| 1346858487 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 560, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1295343341 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 640, Charlotte, NC 28204-3215 | 2020-07-15 |
| 1881212215 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 520, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1720606486 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 400, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1720606445 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 430, Charlotte, NC 28204-3215 | 2020-07-09 |
| 1235757352 | The Presbyterian Hospital | Internal Medicine | 125 Queens Rd Ste 420, Charlotte, NC 28204-3215 | 2020-07-07 |
| 1811517311 | Rowan Regional Medical Center, Inc. | Internal Medicine | 631 Mocksville Ave, Ste 1020, Salisbury, NC 28144-2731 | 2020-04-24 |
| 1154955995 | Mohamed Sobhy Elhusseini Yassin | Internal Medicine | 2400 Pratt St Ste 5000, Durham, NC 27705-3976 | 2020-03-02 |
| 1164944377 | David Michael Ashley | Internal Medicine | Department of Neurosurgery Duke University Ctr, Durham, NC 27710-0001 | 2017-07-10 |
| Find all providers with the same taxonomy | ||||
| City | WAKE FOREST |
| Zip Code | 27587 |
Please comment or provide details below to improve the information on PERSONALIZED HEMATOLOGY-ONCOLOGY OF WAKE FOREST PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.