Susan Wicke, MD, PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

36618 Issued in NC

Legal business name

SUSAN WICKE, MD, PC

Doing business as

Susan Wicke, MD

Practice address

112 Swift Ave
Durham, NC 27705-4800

Phone

(919) 493-3932

Fax

(919) 493-3932

NPI assigned

Jan 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan Holly Wicke, M.D.

Title

Psychiatrist

Phone

(919) 493-3932

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Susan Wicke, MD Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1629121223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SWIFT AVENUE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27705",
            "telephone_number": "919-493-3932",
            "fax_number": "919-493-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SWIFT AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054800",
            "telephone_number": "919-493-3932",
            "fax_number": "919-493-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN WICKE, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "WICKE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "HOLLY",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "919-493-3932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "36618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "130949",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER NUMBER",
            "identifier": "87341",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Wicke, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Surrent Capital, Inc (Cobb's Home Care Specialists)
• Survivor Friendly LLC
• Richard Surwit
• Mary Surya
• Susan Saenger, PLLC
• Philip Willard Susann, PA-C, MPAS
• David Michael Susco, M.D.
• Sharon Matarlo Suson, M.D.
• Tushar Natvarlal Suthar, M.D.
• Mary Kathryn Sutherland, MA, LCMHCA

• Medical Specialty Clinic/Center in Durham, NC
• Providers in Durham, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.