Individual
MICHAEL JOHN MEDVECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BUILDING 1ST FLR, NEW HAVEN, CT 06519-1369
(203) 785-5656
(203) 785-7132
Mailing address
PO BOX 9805, 300 GEORGE ST 6TH FLOOR, NEW HAVEN, CT 06536-0805
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
039676
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001396763
—
CT
Enumeration date
11/30/2005
Last updated
12/03/2007
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