Organization
TRIAD INTERNAL MEDICINE ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTI GILLIAM SELLARS (PRACTICE MANAGER)
(386) 230-0402
Entity
Organization
Contact information
Practice address
1593 YANCEYVILLE ST, SUITE 200, GREENSBORO, NC 27405-6948
(336) 230-0402
(336) 230-1761
Mailing address
1593 YANCEYVILLE ST, SUITE 200, GREENSBORO, NC 27405-6948
(336) 230-0402
(336) 230-1761
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890296U
—
NC
01
—
CI5242
RAILROAD MEDICARE
NC
Enumeration date
09/14/2006
Last updated
06/24/2010
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