Provider Demographics
NPI:1710191069
Name:TRIANGLE NEUROPSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:TRIANGLE NEUROPSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-401-6212
Mailing Address - Street 1:3713 UNIVERSITY DR
Mailing Address - Street 2:STE B
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6202
Mailing Address - Country:US
Mailing Address - Phone:919-401-6212
Mailing Address - Fax:919-401-4170
Practice Address - Street 1:3713 UNIVERSITY DR
Practice Address - Street 2:STE B
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6202
Practice Address - Country:US
Practice Address - Phone:919-401-6212
Practice Address - Fax:919-401-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921983Medicaid
NC2342762Medicare PIN