| West Side Medical Center, Llc | |
|
606 W Main St Norwich CT 06360-6007 | |
| (860) 889-1400 | |
| (860) 889-3163 |
| Full Name | West Side Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 606 W Main St, Norwich, Connecticut |
| Authorized Official Name and Position | William H Hernandez (OWNER) |
| Authorized Official Contact | 8608891400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Medical Center, Llc 606 W Main St Norwich CT 06360-6007 Ph: (860) 889-1400 | West Side Medical Center, Llc 606 W Main St Norwich CT 06360-6007 Ph: (860) 889-1400 |
| NPI Number | 1760537013 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 12/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760537013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 207Q00000X (Connecticut) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 005383 (Connecticut) | Secondary |
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