| Main Medical-mystic, Llc | |
|
23 Clara Dr Suite 201 Mystic CT 06355-1959 | |
| (860) 536-1666 | |
| (860) 536-9770 |
| Full Name | Main Medical-mystic, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 23 Clara Dr, Mystic, Connecticut |
| Authorized Official Name and Position | Roy Martin Main (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8605361666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Medical-mystic, Llc 23 Clara Dr Suite 201 Mystic CT 06355-1959 Ph: (860) 536-1666 | Main Medical-mystic, Llc 23 Clara Dr Suite 201 Mystic CT 06355-1959 Ph: (860) 536-1666 |
| NPI Number | 1003001850 |
|---|---|
| Provider Enumeration Date | 09/13/2007 |
| Last Update Date | 09/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003001850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 031865 (Connecticut) | Primary |
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