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General NPI Number Information
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NPI Number | 1780712125
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Entity Type | Organization
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Legal Business Name | STAMFORD SURGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1351 WASHINGTON BLVD FL 6
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City | STAMFORD
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State | CT
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Zip | 06902-2419
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Country | US
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Telephone | 203-276-5959
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Fax | 203-276-5969
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Provider Business Mailing Address
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Address Line | 1351 WASHINGTON BLVD 6TH FLOOR
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City | STAMFORD
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State | CT
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Zip | 06902-2419
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Country | US
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Telephone | 203-276-5959
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Fax | 203-276-5969
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHERMAN M BULL
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Credential | MD
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Telephone | 203-276-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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