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Organization
TRIDENT PULMONARY AND CRITICAL CARE PC
Active
Organization
TRIDENT PULMONARY AND CRITICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AKINLOYE JULIUS MAKANJUOLA (PRESIDENT)
(678) 545-8134
Entity
Organization
Contact information
Practice address
483 UPPER RIVERDALE RD SW STE E, RIVERDALE, GA 30274-2579
(678) 545-8134
Mailing address
483 UPPER RIVERDALE RD SW STE E, RIVERDALE, GA 30274-2579
(678) 545-8134
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
NULL
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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