Individual
MRS. MARIETTA SOULOG VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
743 HOPE ST, STAMFORD, CT 06907
(203) 964-1212
(203) 348-1585
Mailing address
743 HOPE ST, STAMFORD, CT 06907
(203) 964-1212
(203) 348-1585
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017464
CT
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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