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General NPI Number Information
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NPI Number | 1063901312
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Entity Type | Organization
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Legal Business Name | TRIANGLE SPRINGS PHYSICIAN GROUP, LLC
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 10901 WORLD TRADE BLVD
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City | RALEIGH
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State | NC
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Zip | 27617-4203
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Country | US
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Telephone | 919-746-8900
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Fax | 919-578-5544
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Provider Business Mailing Address
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Address Line | 101 S 5TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-3157
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Country | US
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Telephone | 412-588-3546
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Fax |
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Authorized Official
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Title or Position | EVO - CFO
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Name | GREG MILLER
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Credential |
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Telephone | 412-588-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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