Kimmel, Mark
Kimmel, Mark is an individual health care provider with primary practice located at 536 Saybrook Rd , Middletown CT 06457-4712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Kimmel, Mark can be contacted via phone (860) 358-2220.Contact Information
Primary practice address
536 Saybrook Rd
Middletown CT 06457-4712
Phone: (860) 358-2220
Fax: (860) 358-2222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 031390 | Connecticut |
Profile Details
| NPI number | 1447356522 |
|---|---|
| LBN Legal business name | Kimmel, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447356522 | NPPES |
| Other | 36503 | CHAMPUS | |
| Other | 533929 | CHAMPUS | |
| Other | 031390 | CHAMPUS | |
| Other | 010031390CT03 | CHAMPUS | |
| Other | 0V1840 | CHAMPUS | |
| Other | P399969 | CHAMPUS | |
| MEDICAID | 1313907 | CHAMPUS | |
| Other | 010031390CT03 | CHAMPUS | |
| Other | 0131390 | CHAMPUS | |
| Other | 830001803 | CHAMPUS |
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