| Midstate Medical Group, Pc | |
|
98 Main St Ste 300 Southington CT 06489-2500 | |
| (203) 694-5580 | |
| (860) 620-0446 |
| Full Name | Midstate Medical Group, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 98 Main St Ste 300, Southington, Connecticut |
| Authorized Official Name and Position | Ralph Becker (VICE PRESIDENT, FINANCE) |
| Authorized Official Contact | 8605457602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midstate Medical Group, Pc 98 Main St Ste 300 Southington CT 06489-2500 Ph: (203) 694-5580 | Midstate Medical Group, Pc 98 Main St Ste 300 Southington CT 06489-2500 Ph: (203) 694-5580 |
| NPI Number | 1427089598 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 08/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427089598 | NPI | - | NPPES |
| 004260022 | Medicaid | CT |
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