Individual
DR. DAVID GRAHAM SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BLDG 148, TROUT AVE, GROTON, CT 06349-5900
(860) 694-3263
(860) 694-4809
Mailing address
BLDG 148, TROUT AVE, GROTON, CT 06349-5900
(860) 694-3263
(860) 694-4809
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
10023
MS
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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