Individual
MALLASETAPPA SHIRANNA UMAPATHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 MAIN ST, WEST HAVEN, CT 06516-4424
(203) 933-4001
(203) 933-3759
Mailing address
309 MAIN ST, WEST HAVEN, CT 06516-4424
(203) 933-4001
(203) 933-3759
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
025441
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001254416
—
CT
Enumeration date
07/13/2006
Last updated
06/06/2013
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