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
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
09/16/2014
Last updated
10/16/2014
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