| Aspire Family Medicine &wellness Center, Llc | |
|
850 N Main Street Ext Bldg 2 Suite C2 Wallingford CT 06492-2400 | |
| (203) 269-9778 | |
| (203) 949-1544 |
| Full Name | Aspire Family Medicine &wellness Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 850 N Main Street Ext, Wallingford, Connecticut |
| Authorized Official Name and Position | Michael A Clark (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2032699778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspire Family Medicine &wellness Center, Llc 850 N Main Street Ext Bldg 2 Suite C2 Wallingford CT 06492-2400 Ph: (203) 269-9778 | Aspire Family Medicine &wellness Center, Llc 850 N Main Street Ext Bldg 2 Suite C2 Wallingford CT 06492-2400 Ph: (203) 269-9778 |
| NPI Number | 1821284407 |
|---|---|
| Provider Enumeration Date | 09/18/2007 |
| Last Update Date | 09/18/2007 |
| Medicare PECOS PAC ID | 7517047699 |
|---|---|
| Medicare Enrollment ID | O20080102000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821284407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael A Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912903949 PECOS PAC ID: 6406755040 Enrollment ID: I20040102000683 |
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