Organization
SURGICAL ASSOCIATES OF NORWICH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY J MARTIN (OFFICE MANAGER)
(860) 889-3841
Entity
Organization
Contact information
Practice address
330 WASHINGTON ST, SUITE 520, NORWICH, CT 06360
(860) 889-3841
(860) 887-3840
Mailing address
330 WASHINGTON ST, SUITE 520, NORWICH, CT 06360
(860) 889-3841
(860) 887-3840
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
016369
CT
208600000X
Surgery Physician
030790
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010016369CT02
ANTHEM BCBS
CT
01
—
031272
HEALTH NET
CT
01
—
1021476
AETNA
CT
01
—
180867
PREFERRED ONE
CT
01
—
2590570-003
CIGNA
CT
01
—
C02296
MEDICARE GROUP NUMBER
CT
01
—
NLS046
OXFORD
CT
Enumeration date
12/05/2006
Last updated
08/02/2007
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