Organization
SLEEP MEDICINE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MAHLON SHOUP M.D. (OWNER)
(860) 432-5600
Entity
Organization
Contact information
Practice address
112 SPENCER ST, MANCHESTER, CT 06040-4601
(860) 432-5600
(860) 432-5622
Mailing address
112 SPENCER ST, MANCHESTER, CT 06040-4601
(860) 432-5600
(860) 432-5622
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
12/04/2013
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