Organization
TRIAD INTERVENTIONAL PAIN CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARSHA V GARVIN M.D. (PRESIDENT/PHYSICIAN)
(704) 645-7196
Entity
Organization
Contact information
Practice address
900 OLD WINSTON RD, SUITE 112, KERNERSVILLE, NC 27284-9964
(704) 645-7196
(704) 658-0418
Mailing address
900 OLD WINSTON RD, SUITE 112, KERNERSVILLE, NC 27284-9964
(704) 645-7196
(704) 658-0418
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
2005-00043
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1380R
BCBSNC
NC
05
—
5950096
—
NC
Enumeration date
05/15/2008
Last updated
10/23/2008
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