Individual
KOMSU F MAMUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1260 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4362
(860) 258-3477
(860) 571-6802
Mailing address
2110 SILAS DEANE HIGHWAY, ROCKY HILL, CT 06067
(860) 258-3470
(860) 571-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
047922
CT
207RC0000X
Cardiovascular Disease Physician
Primary
047922
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047922
LICENSE
CT
Enumeration date
02/17/2006
Last updated
03/08/2012
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