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Organization
TRIAD MEDICAL GROUP PA
Active
Organization
TRIAD MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEKITA CLYBURN (BILLING ADMINISTRATION)
(336) 790-9787
Entity
Organization
Contact information
Practice address
2031 MARTIN LUTHER KING JR DR, GREENSBORO, NC 27406-3342
(704) 838-0516
(704) 838-0565
Mailing address
2031 MARTIN LUTHER KING JR DR STE A, GREENSBORO, NC 27406-3300
(336) 790-9787
(336) 790-9786
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39460
NC
207R00000X
Internal Medicine Physician
39460
NC
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/04/2016
Last updated
08/06/2019
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