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General NPI Number Information
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NPI Number | 1952642142
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Entity Type | Organization
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Legal Business Name | TRIANGLE WELLNESS PLLC
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 7940 WILLIAMS POND LN 150
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City | CHARLOTTE
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State | NC
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Zip | 28277-8766
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Country | US
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Telephone | 704-752-7779
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Fax | 704-752-7775
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Provider Business Mailing Address
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Address Line | 530 NEW WAVERLY PL SUITE 301
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City | CARY
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State | NC
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Zip | 27518-7414
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Country | US
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Telephone | 919-851-3480
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Fax |
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Authorized Official
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Title or Position | MEMBER, MEDICAL DIRECTOR
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Name | DR. GREGORY BRANNON
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Credential | M.D.
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Telephone | 919-851-3480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VB0002X
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Taxonomy Name | Obesity Medicine (Obstetrics & Gynecology) Physician
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License Number | 36499
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License Number State | NC
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