Organization
TRIANGLE SURGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR A MEDINA M.D. (PRESIDENT)
(919) 851-5055
Entity
Organization
Contact information
Practice address
1006 PROCURE DR, SUITE 200, FUQUAY VARINA, NC 27526-2627
(919) 552-1050
(919) 552-1055
Mailing address
115 CRESCENT COMMONS DR, SUITE 200, CARY, NC 27518-8102
(919) 851-5055
(919) 851-3065
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199N
BCBS NC
NC
05
—
890199N
—
NC
01
—
CA2892
MEDICARE RAILROAD
NC
Enumeration date
08/21/2007
Last updated
08/21/2007
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