Provider Demographics
NPI:1891919361
Name:TRIANGLE INTERNAL MEDICINE & NEPHROLOGY ASSOCATES PA
Entity Type:Organization
Organization Name:TRIANGLE INTERNAL MEDICINE & NEPHROLOGY ASSOCATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALUBHAI
Authorized Official - Middle Name:NARANBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-233-3435
Mailing Address - Street 1:1831 LAKE PINE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6479
Mailing Address - Country:US
Mailing Address - Phone:919-233-3435
Mailing Address - Fax:919-859-2424
Practice Address - Street 1:1831 LAKE PINE DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6479
Practice Address - Country:US
Practice Address - Phone:919-233-3435
Practice Address - Fax:919-859-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890139MMedicaid
NC2141509CMedicare PIN
NCB98061Medicare UPIN