Individual
DR. MOHAMMED A MEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 SILAS DEANE HWY, SUITE #210, WETHERSFIELD, CT 06109-2124
(860) 436-9880
(860) 436-9850
Mailing address
415 SILAS DEANE HWY, SUITE 210, WETHERSFIELD, CT 06109-2124
(860) 436-9880
(860) 436-9850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
042588
CT
207R00000X
Internal Medicine Physician
Primary
042588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001425885
—
CT
01
—
00142588500
BLUE CARE FAMILY PLAN
CT
01
—
010042588CT01
ANTHEM BLUE CROSS
—
01
—
042588
CONNECTICARE
—
01
—
2V7183
HEALTH NET
—
01
—
36663
HEALTH NEW ENGLAND
—
01
—
3722953
AETNA
—
01
—
4637105
CIGNA
—
01
—
P3623891
OXFORD
—
Enumeration date
05/11/2006
Last updated
08/27/2014
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