MEDICARE: TRIANGLE WELLNESS 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
1	207VB0002X	Obesity Medicine (Obstetrics & Gynecology) Physician	36499	NC

General Provider Information

NPI Number	:	1952642142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIANGLE WELLNESS PLLC

Provider Business Mailing Address
First Line	:	530 NEW WAVERLY PL
Second Line	:	SUITE 301
City	:	CARY
State	:	NC
Zip	:	27518-7414
Country	:	US
Telephone Number	:	919-851-3480
Fax Number	:

Provider Business Practice Location Address
First Line	:	7940 WILLIAMS POND LN
Second Line	:	150
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-8766
Country	:	US
Telephone Number	:	704-752-7779
Fax Number	:	704-752-7775

Authorized Official
Title or Position	:	MEMBER, MEDICAL DIRECTOR
Name	:	DR. GREGORY BRANNON
Credential	:	M.D.
Telephone Number	:	919-851-3480

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	03/13/2013

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Directions to “TRIANGLE WELLNESS PLLC ” Practice Location

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