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Organization
TRUSTEES OF TRINITY COLLEGE
Active
Organization
TRUSTEES OF TRINITY COLLEGE
Active
Other names
Trinity College Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D. RENWICK (DIRECTOR OF ATHLETICS)
(860) 297-2055
Entity
Organization
Contact information
Practice address
300 SUMMIT ST, FERRIS ATHLETIC CENTER, HARTFORD, CT 06106-3100
(860) 297-2575
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
09/16/2014
Last updated
10/16/2014
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