MEDICARE: DR. MARIE J TRENGA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	31524	GA
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	31524	GA

General Provider Information

NPI Number	:	1932173440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE J TRENGA M.D.

Provider Business Mailing Address
First Line	:	1900 10TH AVE
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3600
Country	:	US
Telephone Number	:	706-561-4530
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 10TH AVE
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3600
Country	:	US
Telephone Number	:	706-561-4530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	08/19/2011

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