Individual
THOMAS A COLLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 OLDE TOWNE PKWY STE 150A, MARIETTA, GA 30068-4357
(770) 509-1025
(770) 509-1884
Mailing address
4800 OLDE TOWNE PKWY STE 150A, MARIETTA, GA 30068-4357
(770) 509-1025
(770) 509-1884
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
016568
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000243746
—
GA
Enumeration date
02/14/2006
Last updated
03/19/2018
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