Individual
MUSTANSAR MIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
263 FARMINGTON AVENUE, FARMINGTON, CT 06030
(860) 679-4477
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-4165
(860) 676-3413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
071960
CT
207R00000X
Internal Medicine Physician
278556
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2016
Last updated
08/16/2022
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