Organization
WEST SIDE MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM H HERNANDEZ III M.D. (OWNER)
(860) 889-1400
Entity
Organization
Contact information
Practice address
606 W MAIN ST, NORWICH, CT 06360-6007
(860) 889-1400
(860) 889-3163
Mailing address
606 W MAIN ST, NORWICH, CT 06360-6007
(860) 889-1400
(860) 889-3163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207Q00000X
CT
363LF0000X
Family Nurse Practitioner
005383
CT
Other
Enumeration date
01/25/2007
Last updated
12/03/2013
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