SUSAN WICKE, MD
NPI 1629121223
Clinic/Center - Medical Specialty in Durham, NC

Q: What is Susan Wicke, MD, PC's NPI number?

The NPI number for Susan Wicke, MD, PC is 1629121223. It was assigned to this organization in the NPPES registry on January 19, 2007.

Q: What is Susan Wicke, MD, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since January 19, 2007

112 SWIFT AVE, DURHAM, NC 27705(919) 493-3932(919) 493-3932 Get Directions Write a Review

NPPES record last updated: August 23, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Susan Wicke, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN WICKE, MD (NPI 1629121223) is a healthcare organization registered as a medical specialty in Durham, North Carolina and active in the NPI registry since January 2007. The organization lists Susan Holly Wicke, Psychiatrist, as its authorized official.

NPPES Registry Identity

NPI1629121223

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameSUSAN WICKE, MD, PC

Location Address112 SWIFT AVEDurham, NC 27705-4800

Mailing Address112 Swift AvenueDurham, NC 27705 · (919) 493-3932 · Fax (919) 493-3932

Phone(919) 493-3932

Fax(919) 493-3932

Organization SubpartNo

Authorized OfficialSusan Holly WickePsychiatrist · (919) 493-3932

Enumeration DateJanuary 19, 2007

Last NPPES UpdateAugust 23, 2007

✔ NPI 1629121223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

License✔ Licensed in NC · 36618

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).

112 SWIFT AVE, Durham, NC 27705

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Other Names 1

Doing Business AsSusan Wicke, Md

Other Identifiers 4

Other130949NC · Cigna Behavioral Health

Medicare UPINF58331NC

Other87341NC · Bcbsnc Provider Number

Medicare ID-Type Unspecified2188551ANC

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH A. SHAW PH.D

Psychologist