| Fairfield County Medical Group, PC | |
|
15 Corporate Dr Suite 2-1 Trumbull CT 06611-1351 | |
| (203) 459-5100 | |
| (203) 452-2424 |
| Full Name | Fairfield County Medical Group, PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 15 Corporate Dr, Trumbull, Connecticut |
| Authorized Official Name and Position | Frank Spano (PRESIDENT) |
| Authorized Official Contact | 2034595100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield County Medical Group, PC 15 Corporate Dr Suite 2-1 Trumbull CT 06611-1351 Ph: (203) 459-5100 | Fairfield County Medical Group, PC 15 Corporate Dr Suite 2-1 Trumbull CT 06611-1351 Ph: (203) 459-5100 |
| NPI Number | 1639195415 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639195415 | NPI | - | NPPES |
| C12675 | Other | CT | RAILROAD MEDICARE PTAN |
| 50FFLDCMGCT01 | Other | CT | ANTHEM BLUE CROSS BLUE SH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 028987 (Connecticut) | Primary |
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