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Organization
TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC
Active
Organization
TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARINA GIBBS (CFO)
(678) 472-3734
Entity
Organization
Contact information
Practice address
6524 OLD NATIONAL HWY, BLDG. B, STE 102, ATLANTA, GA 30349
(678) 472-3734
Mailing address
6524 OLD NATIONAL HWY, BLDG. B, STE 102, ATLANTA, GA 30349
(678) 472-3734
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407950876
PEDIATRIC MEDICINE
GA
Enumeration date
08/16/2021
Last updated
08/16/2021
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