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NPI Code Detail

MEDICARE: TRIAD URGENT CARE PLLC

MEDICARE: TRIAD URGENT CARE PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1255727962
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIAD URGENT CARE PLLC
Provider Business Mailing Address
First Line : 2005 PISGAH CHURCH RD
Second Line : SUITE A
City : GREENSBORO
State : NC
Zip : 27455-3309
Country : US
Telephone Number : 336-701-2662
Fax Number :
Provider Business Practice Location Address
First Line : 2005 PISGAH CHURCH RD
Second Line : SUITE A
City : GREENSBORO
State : NC
Zip : 27455-3309
Country : US
Telephone Number : 336-701-2662
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHAEL Y GHIM
Credential : MD
Telephone Number : 336-701-2662
Provider Enumeration Date : 04/09/2015
Last Update Date : 04/08/2016

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Directions to “TRIAD URGENT CARE PLLC ” Practice Location

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