Provider Demographics
NPI:1588976351
Name:OSSELYN, TRINIDAD D (MD)
Entity type:Individual
Prefix:
First Name:TRINIDAD
Middle Name:D
Last Name:OSSELYN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:770-929-1016
Practice Address - Street 1:1125 TOWN CENTER VILLAGE DR
Practice Address - Street 2:KAISER PERMANENTE HENRY TOWNE CENTRE MEDICAL CENTER
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5970
Practice Address - Country:US
Practice Address - Phone:678-583-6600
Practice Address - Fax:770-929-1016
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2022-01-10
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Provider Licenses
StateLicense IDTaxonomies
SCLL32747207Q00000X
GA069081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine