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General NPI Number Information
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NPI Number | 1861685521
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE OF STAMFORD PC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 144 MORGAN ST STE 10
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City | STAMFORD
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State | CT
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Zip | 06905-5433
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Country | US
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Telephone | 203-359-4888
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Fax | 203-359-6983
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Provider Business Mailing Address
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Address Line | 144 MORGAN ST STE 10
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City | STAMFORD
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State | CT
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Zip | 06905-5433
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Country | US
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Telephone | 203-359-4888
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Fax | 203-359-6983
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID M RADIN
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Credential | MD
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Telephone | 203-359-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 033028
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License Number State | CT
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