NPI 1003001850

Main Medical-Mystic, LLC

Organisation Internal Medicine Physician Mystic, CT

Practice location

Address: 23 Clara Dr Suite 201, Mystic, CT 06355-1959
Phone: (860) 536-1666
Fax: (860) 536-9770

Authorised official

Name: Roy Martin Main
Title: Owner/Physician
Phone: (860) 536-1666

Registered specialties

Internal Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence 031865 (CT)

Other Internal Medicine providers in Connecticut →

Registry record

NPI: 1003001850
Entity type: Organization
NPI issued: 13 Sep 2007
Record last updated: 13 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.