Provider Demographics
NPI:1649590381
Name:TRIANGLE ANESTHESIA ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:TRIANGLE ANESTHESIA ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:919-434-9350
Mailing Address - Street 1:4441 SIX FORKS RD STE 106
Mailing Address - Street 2:BOX 136
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5729
Mailing Address - Country:US
Mailing Address - Phone:919-434-9350
Mailing Address - Fax:
Practice Address - Street 1:2600 ATLANTIC AVE STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1502
Practice Address - Country:US
Practice Address - Phone:919-881-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty