| Coastal Digestive Diseases Pc | |
|
234 Bank St 4th Floor New London CT 06320-6070 | |
| (860) 442-0290 | |
| (860) 442-2136 |
| Full Name | Coastal Digestive Diseases Pc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 234 Bank St, New London, Connecticut |
| Authorized Official Name and Position | George S Ouellette (PRESIDENT) |
| Authorized Official Contact | 8604420290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Digestive Diseases Pc 234a Bank St 4th Floor New London CT 06320-6054 Ph: (860) 442-0290 | Coastal Digestive Diseases Pc 234 Bank St 4th Floor New London CT 06320-6070 Ph: (860) 442-0290 |
| NPI Number | 1053441147 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 12/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053441147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 3032224000 (Connecticut) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | 3032224000 (Connecticut) | Secondary |
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