Provider Demographics
NPI:1952642142
Name:TRIANGLE WELLNESS PLLC
Entity Type:Organization
Organization Name:TRIANGLE WELLNESS PLLC
Other - Org Name:MEDI WEIGHTLOSS CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-851-3480
Mailing Address - Street 1:530 NEW WAVERLY PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7414
Mailing Address - Country:US
Mailing Address - Phone:919-851-3480
Mailing Address - Fax:
Practice Address - Street 1:7940 WILLIAMS POND LN
Practice Address - Street 2:150
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8766
Practice Address - Country:US
Practice Address - Phone:704-752-7779
Practice Address - Fax:704-752-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36499207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity MedicineGroup - Single Specialty