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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