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Susan Wicke, Md, Pc
Medical Specialty Clinic/Center in Durham, North Carolina
NPI 1629121223

Susan Wicke, Md, Pc is a Medical Specialty Clinic/Center based in Durham, NC and is specialized in Medical Specialty. Susan Wicke, Md, Pc practices in Durham, NC. The NPI Number for Susan Wicke, Md, Pc is 1629121223 and holds a License No. 36618 (North Carolina).

The current practice location address for Susan Wicke, Md, Pc is 112 Swift Ave, Durham, NC and can be reached out via phone at 919-493-3932 and via fax at 919-493-3932.

Location: 112 Swift Ave, Durham, NC, 27705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629121223
Provider Name
Susan Wicke, Md, Pc
Credential
Provider Entity Type
Organization
Address
112 Swift Ave, Durham, NC, 27705
Phone Number
919-493-3932
Fax Number
919-493-3932
Provider Enumeration Date
01/19/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
130949 01 NC CIGNA BEHAVIORAL HEALTH
87341 01 NC BCBSNC PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
112 Swift Ave
City
Durham
State
North Carolina
Zip
27705-4800
Phone Number
919-493-3932
Fax Number
919-493-3932
person
Provider Business Mailing Address Details
Address
112 Swift Ave
City
Durham
State
North Carolina
Zip
27705-4800
Phone Number
919-493-3932
Fax Number
919-493-3932
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
36618 (North Carolina)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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