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Contact Information

MIDSTATE MEDICAL GROUP, PC
435 LEWIS AVENUE
MIDSTATE MEDICAL GROUP, PC
MERIDEN, CT06451
 Phone: 203-694-8750
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MIDSTATE MEDICAL GROUP, PC

NPI Number 1356361315
LBN Legal business name MIDSTATE MEDICAL GROUP, PC
Authorized official FRED TILDEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/20/2006
Last updated 04/09/2008 - About 18 years ago
Identifiers
CT License # N/A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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