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Individual

DR. MAXIMILIAN GOMEZ-TROCHEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
365 MAIN ST STE 201, WATERTOWN, CT 06795-2249
(860) 274-2418
(860) 274-2986
Mailing address
365 MAIN ST STE 201, WATERTOWN, CT 06795-2249
(860) 274-2418
(860) 274-2986

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
049979
CT
207R00000X
Internal Medicine Physician
49979
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05856125
GREAT WEST
CT
01
1154493
USA
CT
01
5856125
CIGNA
CT
01
717021/627772
WELLCARE
CT
01
P01040202
RAILROAD MEDICARE
CT
01
P4376817
OXFORD
CT
Enumeration date
06/23/2008
Last updated
04/29/2021
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