Individual
SUSAN ALSAMARAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
455 LEWIS AVE, MIDSTATE MEDICAL GROUP, PC, MERIDEN, CT 06451-2121
(203) 238-7747
(203) 686-0282
Mailing address
455 LEWIS AVE, MIDSTATE MEDICAL GROUP, PC, MERIDEN, CT 06451-2121
(203) 238-7747
(203) 238-7747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
050729
CT
207R00000X
Internal Medicine Physician
248940
NY
207RH0003X
Hematology & Oncology Physician
Primary
050729
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CT
Enumeration date
05/24/2007
Last updated
06/24/2012
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