Provider Demographics
NPI:1871112177
Name:WACHS, ERIKA SEKERAK (DO)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:SEKERAK
Last Name:WACHS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 WESFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-9430
Mailing Address - Country:US
Mailing Address - Phone:203-581-3825
Mailing Address - Fax:
Practice Address - Street 1:1635 NC HIGHWAY 66 S STE 210
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3886
Practice Address - Country:US
Practice Address - Phone:336-992-1770
Practice Address - Fax:336-992-1776
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-3977207Q00000X
390200000X
NC2023-00576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program