Healthcare Provider Details

I. General information

NPI: 1427578822
Provider Name (Legal Business Name): TRINA PAL MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 10/31/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR STE 100
DALTON GA
30720-8662
US

IV. Provider business mailing address

1107 MEMORIAL DR STE 100
DALTON GA
30720-8662
US

V. Phone/Fax

Practice location:
  • Phone: 706-529-3072
  • Fax: 706-529-3077
Mailing address:
  • Phone: 706-529-3072
  • Fax: 706-529-3077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101280756
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71921
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number0101280756
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number071921
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number101779
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: