| Triad Medical Group Pa | |
|
2031 Martin Luther King Jr Dr Greensboro NC 27406-3342 | |
| (704) 838-0516 | |
| (704) 838-0565 |
| Full Name | Triad Medical Group Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2031 Martin Luther King Jr Dr, Greensboro, North Carolina |
| Authorized Official Name and Position | Nekita Clyburn (BILLING ADMINISTRATION) |
| Authorized Official Contact | 3367909787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Medical Group Pa 2031 Martin Luther King Jr Dr Ste A Greensboro NC 27406-3300 Ph: (336) 790-9787 | Triad Medical Group Pa 2031 Martin Luther King Jr Dr Greensboro NC 27406-3342 Ph: (704) 838-0516 |
| NPI Number | 1194267336 |
|---|---|
| Provider Enumeration Date | 11/04/2016 |
| Last Update Date | 08/06/2019 |
| Medicare PECOS PAC ID | 4183900210 |
|---|---|
| Medicare Enrollment ID | O20170404000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194267336 | NPI | - | NPPES |
| Provider Name | Linda D Greninger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154488203 PECOS PAC ID: 2062473820 Enrollment ID: I20041025000654 |
| Provider Name | Donna F Odem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205850054 PECOS PAC ID: 3072612092 Enrollment ID: I20070615000332 |
| Provider Name | Ayyaz Mahmood Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730114026 PECOS PAC ID: 1456402312 Enrollment ID: I20090706000581 |
| Provider Name | Shamsher Ahluwalia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497943286 PECOS PAC ID: 9537217385 Enrollment ID: I20090914000424 |
| Provider Name | Kathryn M Wriggelsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407162050 PECOS PAC ID: 3779609789 Enrollment ID: I20100928000460 |
| Provider Name | Lovika L Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235530825 PECOS PAC ID: 5890002117 Enrollment ID: I20160120001829 |
| Provider Name | Paula B Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942672555 PECOS PAC ID: 9436418233 Enrollment ID: I20180124003166 |
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