Organization
TRIANGLE CHILD ABUSE PEDIATRIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN DENISE EVERETT MD (OWNER)
(919) 845-4620
Entity
Organization
Contact information
Practice address
1100 NAVAHO DR, SUITE 121, RALEIGH, NC 27609-7319
(919) 845-4620
(919) 846-8126
Mailing address
PO BOX 1689, ETOWAH, NC 28729-1689
(828) 891-5524
(828) 891-4069
Taxonomy
Speciality
Code
Description
License number
State
2080C0008X
Child Abuse Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5913571
—
NC
Enumeration date
12/18/2009
Last updated
05/17/2010
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