Real Life Medical Llc | |
1245 Farmington Ave # 226 West Hartford CT 06107-2667 | |
(860) 470-6630 | |
(862) 298-0763 |
Full Name | Real Life Medical Llc |
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Speciality | Internal Medicine |
Location | 1245 Farmington Ave # 226, West Hartford, Connecticut |
Authorized Official Name and Position | Karl Michael Dauphinais (OWNER) |
Authorized Official Contact | 8604706630 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Real Life Medical Llc 1245 Farmington Ave # 226 West Hartford CT 06107-2667 Ph: (860) 470-6630 | Real Life Medical Llc 1245 Farmington Ave # 226 West Hartford CT 06107-2667 Ph: (860) 470-6630 |
NPI Number | 1275178642 |
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Provider Enumeration Date | 11/09/2019 |
Last Update Date | 12/04/2019 |
Medicare PECOS PAC ID | 4183052616 |
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Medicare Enrollment ID | O20200317001233 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275178642 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Karl M Dauphinais |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548467897 PECOS PAC ID: 9335231810 Enrollment ID: I20070829000071 |
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