Organization · Type 2 NPI
Coastal Digestive Diseases PC
Adult Medicine Physician · New London, CT
NPI number
1053441147
Active
Practice location
234 Bank St, 4th Floor
New London, CT 06320-6070
Fax (860) 442-2136
Mailing address
234A Bank St, 4th Floor
New London, CT 06320-6054
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | 3032224000 (CT) |
| Gastroenterology Physician | 207RG0100X | 3032224000 (CT) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1053441147
Coastal Digestive Diseases PC's National Provider Identifier is 1053441147, issued on Mar 7, 2007. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in New London, CT. The record was last updated on Dec 7, 2011.