Provider Demographics
NPI:1558716589
Name:TRIANGLE WELLNESS PLLC
Entity Type:Organization
Organization Name:TRIANGLE WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-504-7035
Mailing Address - Street 1:16623 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5621
Mailing Address - Country:US
Mailing Address - Phone:704-504-7035
Mailing Address - Fax:704-973-9523
Practice Address - Street 1:16623 BIRKDALE COMMONS PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5621
Practice Address - Country:US
Practice Address - Phone:704-504-7035
Practice Address - Fax:704-973-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty