Organization
MDLIVE MEDICAL GROUP TX PLLC
Active
Parent organization
MDLIVE MEDICAL GROUP TX PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MDLIVE MEDICAL GROUP TX PLLC
Authorized official
SUE-ANN ADRIANS (GP PM)
(945) 275-1345
Entity
Organization
Contact information
Practice address
900 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-2920
(800) 400-6354
Mailing address
PO BOX 5006, HARTFORD, CT 06102-5006
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/04/2022
Last updated
05/04/2026
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