| Mwl-wallingford | |
|
1243 S Broad St Wallingford CT 06492-1737 | |
| (203) 446-4555 | |
| Not Available |
| Full Name | Mwl-wallingford |
|---|---|
| Speciality | Family Medicine |
| Location | 1243 S Broad St, Wallingford, Connecticut |
| Authorized Official Name and Position | Pranav Shah (OWNERE) |
| Authorized Official Contact | 2034464555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mwl-wallingford 1243 S Broad St Wallingford CT 06492-1737 Ph: (203) 446-4555 | Mwl-wallingford 1243 S Broad St Wallingford CT 06492-1737 Ph: (203) 446-4555 |
| NPI Number | 1346858867 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346858867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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