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NPI Code Detail

MEDICARE: TRIANGLE ANESTHESIA ASSOCIATES, PLLC

MEDICARE: TRIANGLE ANESTHESIA ASSOCIATES, 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
1367500000XCertified Registered Nurse Anesthetist

General Provider Information

NPI Number : 1649590381
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIANGLE ANESTHESIA ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 4441 SIX FORKS RD STE 106
Second Line : BOX 136
City : RALEIGH
State : NC
Zip : 27609-5729
Country : US
Telephone Number : 919-434-9350
Fax Number :
Provider Business Practice Location Address
First Line : 2600 ATLANTIC AVE STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27604-1502
Country : US
Telephone Number : 919-881-9999
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MR. DAVID W PHILLIPS
Credential : CRNA
Telephone Number : 919-434-9350
Provider Enumeration Date : 06/04/2010
Last Update Date : 06/04/2010

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