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Organization
MEDICAL DIAGNOSTIC GROUP,P.C.
Active
Organization
MEDICAL DIAGNOSTIC GROUP,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L DOUGLAS M.D. (PRESIDENT)
(845) 342-5681
Entity
Organization
Contact information
Practice address
210 E MAIN ST, MIDDLETOWN, NY 10940-4038
(845) 342-5681
(845) 342-0470
Mailing address
210 E MAIN ST, MIDDLETOWN, NY 10940-4038
(845) 342-5681
(845) 342-0470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01003254
—
NY
01
—
CF7464
RAILROAD MEDICARE
NY
Enumeration date
05/22/2006
Last updated
04/24/2008
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