SUMAN M WASAN (NPI# 1427027242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427027242 |
| Entity Type | Individual |
| Full Name | SUMAN M WASAN |
| Credential | MD |
| Practice Address |
4414 Lake Boone Trl Ste 108 Raleigh NC 27607 |
| Mailing Address |
4414 Lake Boone Trl Ste 108 Raleigh NC 27607-7522 |
| Practice Telephone | 9197842300 |
| Mailing Telephone | 9197842300 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2019-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 19450 | OK | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
2019-01868 | NC | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
19450 | OK | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
19450 | OK | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4414 Lake Boone Trl Ste 108, Raleigh, NC 276077522 | 9197842300 | |
| 825 Ne 10th St, Oupb 2500, Oklahoma City, OK 731045417 | 4052717001 |
| Street Address |
4414 LAKE BOONE TRL STE 108 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811960412 | Stephen Wayne Smith | Internal Medicine | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2006-02-13 |
| 1013473180 | Sara Beth Liles | Nurse Practitioner | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2019-02-14 |
| 1871065656 | Morgan Elaine Schultingkemper | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2018-12-18 |
| 1376058024 | Kerri Michele Jones | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2017-12-04 |
| 1871988097 | Kimberly A Trinh | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2015-04-03 |
| 1316386303 | Matthew Edward Gibson | Surgery | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607 | 2013-06-23 |
| 1952745242 | Ryan Joseph Meehan | Surgery | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2013-04-17 |
| 1770547580 | Brandy Cruse Wilson | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1407919285 | Angelo Milazzo | Internal Medicine | 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 | 2006-12-19 |
| 1639253529 | James Wilson Peterson | Internal Medicine | 3320 Wake Forest Rd., Suite 200, Raleigh, NC 27609 | 2006-10-25 |
| 1821010067 | Walter Tan | Internal Medicine | 3000 New Bern Ave Ste 1100, Wpp - Structural Heart, Raleigh, NC 27610-1231 | 2006-07-24 |
| 1164485033 | Glenndale Moore | Internal Medicine | 2949 New Bern Ave, Suite 112-a, Raleigh, NC 27610-1248 | 2006-04-10 |
| 1881680098 | Joseph Anthony Guzzo | Internal Medicine | 4201 Lake Boone Trl, Suite 104, Raleigh, NC 27607-7512 | 2005-09-22 |
| 1972508661 | George Rayburn Cheely | Internal Medicine | 3000 New Bern Ave, Ste 1200, Raleigh, NC 27610-1231 | 2005-06-17 |
| 1245235506 | Sagir Ahmed | Internal Medicine | 3811 Ed Dr, Suite 130, Raleigh, NC 27612-2392 | 2005-06-14 |
| 1104480532 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| 1720643174 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| Find all providers in RALEIGH | ||||
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| 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.