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General NPI Number Information
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NPI Number | 1134184583
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH CARE PA
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 930 W WILSON AVE
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City | MOORESVILLE
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State | NC
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Zip | 28117-8811
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Country | US
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Telephone | 704-663-7500
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Fax | 704-799-2613
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Provider Business Mailing Address
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Address Line | 930 W WILSON AVE
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City | MOORESVILLE
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State | NC
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Zip | 28117-8811
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Country | US
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Telephone | 704-663-7500
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Fax | 704-799-2613
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ANTHONY WAYNE MACASIEB
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Credential | MD
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Telephone | 704-663-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 82291
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 82291
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License Number State | NC
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