Basic Information
| Provider Information | |||||||||
| NPI: | 1548341548 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRININTY MEDICAL CARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2364 UPPER GREENS PL | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234563587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575639291 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1004 FIRST COLONIAL RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234543070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579626262 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GEORGE | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | JOAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7575639291 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101054067 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.