# SERGE P. POULIN, MD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SERGE P. POULIN, MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174712814
- **Legal business name:** SERGE P. POULIN, MD
- **Authorized official:** LOUISE POULIN (MANAGER)
- **Authorized official phone:** (860) 649-6900

## Contact information

- **Practice address:** 315 E CENTER ST, MANCHESTER, CT 06040-5251
- **Practice address phone:** (860) 649-6900
- **Practice address fax:** (860) 647-0469
- **Mailing address:** 315 E CENTER ST, MANCHESTER, CT 06040-5251
- **Mailing address phone:** (860) 649-6900
- **Mailing address fax:** (860) 647-0469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | CT | Yes |

## Other

- **Enumeration date:** 10/18/2007
- **Last updated:** 10/18/2007