Organization
MAIN MEDICAL-MYSTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY MARTIN MAIN M.D. (OWNER/PHYSICIAN)
(860) 536-1666
Entity
Organization
Contact information
Practice address
23 CLARA DR, SUITE 201, MYSTIC, CT 06355-1959
(860) 536-1666
(860) 536-9770
Mailing address
23 CLARA DR, SUITE 201, MYSTIC, CT 06355-1959
(860) 536-1666
(860) 536-9770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
031865
CT
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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