Individual
DR. MARK KIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
536 SAYBROOK RD, MIDDLETOWN, CT 06457-4712
(860) 358-2220
(860) 358-2222
Mailing address
536 SAYBROOK RD, MIDDLETOWN, CT 06457-4712
(860) 358-2220
(860) 358-2222
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
031390
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010031390CT03
BLUECARE FAMILY PLAN
CT
01
—
0131390
UNITED HEALTHCARE
—
01
—
031390
CONNECTICARE
CT
01
—
0V1840
HEALTHNET
CT
05
—
1313907
—
CT
01
—
36503
CHAMPUS
—
01
—
533929
AETNA
—
01
—
830001803
RAILROAD MEDICARE
CT
01
—
P399969
OXFORD
—
Enumeration date
09/15/2006
Last updated
07/08/2007
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