Individual
MICAH DELBERT RICHARD AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 HOSPITAL PLZ, EMERGENCY DEPARTMENT, STAMFORD, CT 06902-3602
(203) 276-7777
Mailing address
1 HOSPITAL PLZ, STAMFORD, CT 06902-3602
(203) 276-7777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
70179
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2018
Last updated
03/16/2023
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