Organization
MDLIVE MEDICAL GROUP PA
Active
Parent organization
MDLIVE MEDICAL GROUP PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
MDLIVE MEDICAL GROUP PA
Authorized official
SUE-ANN ADRIANS (GP PM)
(945) 275-1345
Entity
Organization
Contact information
Practice address
900 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-2920
(800) 400-6354
Mailing address
PO BOX 5006, HARTFORD, CT 06102-5006
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/08/2022
Last updated
05/04/2026
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