Organization
TRIANGLE GERIATRIC AND MEMORY CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SMITH CREDENTIALS (CREDENTIALING COORDINATOR)
(919) 342-6842
Entity
Organization
Contact information
Practice address
907 KILDAIRE FARM RD, CARY, NC 27511-3922
(919) 319-6610
(919) 319-6365
Mailing address
203 MICHELANGELO WAY, CARY, NC 27518-8716
(919) 319-6610
(919) 319-6365
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
2010-00095
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919360
—
NC
Enumeration date
11/05/2013
Last updated
08/14/2023
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