Emily Ferguson Md Llc | |
41a Grove St Putnam CT 06260-2107 | |
(860) 963-0313 | |
Not Available |
Full Name | Emily Ferguson Md Llc |
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Speciality | Family Medicine |
Location | 41a Grove St, Putnam, Connecticut |
Authorized Official Name and Position | Emily Ferguson (PHYSICIAN) |
Authorized Official Contact | 8609630313 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Emily Ferguson Md Llc 41a Grove St Putnam CT 06260-2107 Ph: () - | Emily Ferguson Md Llc 41a Grove St Putnam CT 06260-2107 Ph: (860) 963-0313 |
NPI Number | 1225344781 |
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Provider Enumeration Date | 08/23/2010 |
Last Update Date | 07/26/2013 |
Medicare PECOS PAC ID | 2264556109 |
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Medicare Enrollment ID | O20100831000002 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225344781 | NPI | - | NPPES |
001369752 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036975 (Connecticut) | Primary |
Provider Name | Emily Ferguson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710989520 PECOS PAC ID: 3173647013 Enrollment ID: I20100831000004 |
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