Main Medical-Mystic, LLC
Internal Medicine in Mystic, Connecticut
1003001850- Practice location
- 23 Clara Dr, Suite 201, Mystic, CT 06355-1959
- Phone
- 860-536-1666
- Fax
- 860-536-9770
- Last updated
- September 13, 2007
Main Medical-Mystic, LLC is a healthcare organization based in Mystic, CT. Main Medical-Mystic, LLC practices in Mystic, CT. The NPI Number for Main Medical-Mystic, LLC is 1003001850 and holds a License No. 031865 (CT). The current practice location address for Main Medical-Mystic, LLC is 23 Clara Dr, Suite 201, Mystic, CT 06355-1959 and can be reached out via phone at 860-536-1666 and via fax at 860-536-9770.
Provider Profile Details
- NPI Number
- 1003001850
- Provider Name
- Main Medical-Mystic, LLC
- Provider Entity Type
- Organization
- Address
- 23 Clara Dr, Suite 201, Mystic, CT 06355-1959
- Phone Number
- 860-536-1666
- Fax Number
- 860-536-9770
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Roy Martin Main, MD · Owner/Physician · 860-536-1666
- Provider Enumeration Date
- September 13, 2007
- Last Update Date
- September 13, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 23 Clara Dr
Suite 201
Mystic, CT 06355-1959 - City
- Mystic
- State
- Connecticut
- Zip
- 06355-1959
- Phone Number
- 860-536-1666
- Fax Number
- 860-536-9770
Provider Business Mailing Address Details
- Address
- 23 Clara Dr
Suite 201
Mystic, CT 06355-1959 - City
- Mystic
- State
- CT
- Zip
- 06355-1959
- Phone Number
- 860-536-1666
- Fax Number
- 860-536-9770
License Information
- License Number
- 031865
- License State
- CT
- Taxonomy
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Internal Medicine providers near Mystic, CT
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- Dr. Howard Brensilver, MDInternal Medicine · NPI 1336134451
- Dr. James D Scarles, MDInternal Medicine · NPI 1194710269
- Dr. James F Sullivan, MDInternal Medicine · NPI 1780679472
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Frequently Asked Questions
What is the NPI number of Main Medical-Mystic, LLC?
The NPI number of Main Medical-Mystic, LLC is 1003001850. It was assigned on September 13, 2007 and is currently active in the NPPES registry.
What is the specialty of Main Medical-Mystic, LLC?
Main Medical-Mystic, LLC is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in CT under license number 031865.
Where does Main Medical-Mystic, LLC practice?
The practice location is 23 Clara Dr, Suite 201, Mystic, CT 06355-1959. The office can be reached at 860-536-1666 (phone) or 860-536-9770 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1003001850 directly on the NPPES registry website.