| Serge P. Poulin, Md | |
|
629 E Middle Tpke Manchester CT 06040-3731 | |
| (860) 649-6900 | |
| (860) 647-0469 |
| Full Name | Serge P. Poulin, Md |
|---|---|
| Speciality | Family Medicine |
| Location | 629 E Middle Tpke, Manchester, Connecticut |
| Authorized Official Name and Position | Lousie Poulin (OFFICE MANAGER) |
| Authorized Official Contact | 8606496900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Serge P. Poulin, Md 629 E Middle Tpke Manchester CT 06040-3731 Ph: (860) 649-6900 | Serge P. Poulin, Md 629 E Middle Tpke Manchester CT 06040-3731 Ph: (860) 649-6900 |
| NPI Number | 1770860504 |
|---|---|
| Provider Enumeration Date | 11/08/2011 |
| Last Update Date | 11/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770860504 | NPI | - | NPPES |
| 0027117 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 027117 (Connecticut) | Primary |
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