Individual
CONNIE A TRELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1350 WALTON WAY, 3RD FL CRITICAL CARE MEDICINE, AUGUSTA, GA 30901-2612
(706) 774-5713
(706) 774-5792
Mailing address
1350 WALTON WAY, 3RD FL CRITICAL CARE MEDICINE, AUGUSTA, GA 30901-2612
(706) 774-5713
(706) 774-5792
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
043495
GA
207RP1001X
Pulmonary Disease Physician
Primary
043495
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000736766E
—
GA
05
—
000736766F
—
GA
05
—
G43495
—
SC
Enumeration date
11/14/2005
Last updated
01/22/2015
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