Organization
WEST HAVEN MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANURUDDHA WALALIYADDA M.D. (MANAGING PARTNER)
(203) 932-6481
Entity
Organization
Contact information
Practice address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Mailing address
687 CAMPBELL AVE, WEST HAVEN, CT 06516-3774
(203) 932-6481
(203) 932-4051
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
016797
CT
207R00000X
Internal Medicine Physician
Primary
016636
CT
Other
Enumeration date
07/08/2005
Last updated
01/21/2014
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