Individual
DR. MICHAEL E IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 GAYLORD FARM RD, WALLINGFORD, CT 06492-2899
(203) 284-2800
Mailing address
50 GAYLORD FARM RD, WALLINGFORD, CT 06492-2899
(203) 284-2800
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
035224
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001352244
—
CT
Enumeration date
08/07/2006
Last updated
09/03/2025
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