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Organization

PREMIER MEDICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN RODIS M.D. (PRESIDENT)
(203) 276-7295
Entity
Organization

Contact information

Practice address
31 STRAWBERRY HILL AVE, STAMFORD, CT 06902-2608
(203) 325-8888
(203) 359-2344
Mailing address
31 STRAWBERRY HILL AVE, STAMFORD, CT 06902-2608
(203) 325-8888
(203) 359-2344

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
225100000X
Physical Therapist
363A00000X
Physician Assistant

Other

Enumeration date
10/21/2008
Last updated
10/21/2008
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