Healthcare Provider Details

I. General information

NPI: 1578263133
Provider Name (Legal Business Name): TRIANGLE ANESTHESIA GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/03/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 WEEPING WILLOW DR
DURHAM NC
27704-6206
US

IV. Provider business mailing address

PO BOX 15902
DURHAM NC
27704-0902
US

V. Phone/Fax

Practice location:
  • Phone: 203-820-9397
  • Fax: 866-586-3722
Mailing address:
  • Phone: 203-820-9397
  • Fax: 866-586-3722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. FRITZ MESILIEN
Title or Position: OWNER
Credential: CRNA
Phone: 203-820-9397