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Organization
TRIANGLE MEDICAL PROFESSIONALS LLC
Active
Organization
TRIANGLE MEDICAL PROFESSIONALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A BLELLOCH PA (MANAGING PA)
(919) 870-8845
Entity
Organization
Contact information
Practice address
8512 SIX FORKS RD, SUITE 102B, RALEIGH, NC 27615-3255
(919) 870-8845
Mailing address
6512 SIX FORKS RD, SUITE 102B, RALEIGH, NC 27615-6561
(919) 870-8845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
132522
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132522
GROUP MEDICAL BOARD LICEN
NC
Enumeration date
07/17/2006
Last updated
03/25/2010
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