NPI 1174201156

Mdlive Medical Group Nm, LLC

Organisation Dermatology Physician Bloomfield, CT

Practice location

Address: 900 Cottage Grove Rd, Bloomfield, CT 06002-2920
Phone: (800) 400-6354
Mailing address: PO Box 5006, Hartford, CT 06102-5006

Authorised official

Name: Sue-Ann Adrians
Title: Gp Pm
Phone: (800) 400-6354

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Connecticut →

Registry record

NPI: 1174201156
Entity type: Organization
NPI issued: 10 Jul 2023
Record last updated: 10 Apr 2026

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.