NPI | 1043894504 |
---|---|
Doing Business As | TRIAD INTERNAL MEDICINE |
Entity Type | Organization |
Authorized Contact | ASHLEY LONG Credentialing/Enrollment Specialist 984-333-2741 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine |
Enumeration Date | 2021-05-11 |
Last Update Date | 2023-05-22 |