Main Medical-Mystic, LLC

NPI #1003001850 in Mystic, Connecticut

Provider Information

NPI Number: 1003001850
Entity Type: Organization
Organization Name: Main Medical-Mystic, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Sep 13, 2007
Last Updated: Sep 13, 2007

Practice Location

Address: 23 CLARA DR
Address 2: SUITE 201
City: Mystic
State: Connecticut
ZIP Code: 06355-1959
Phone: (860) 536-1666

Authorized Official

Name: DR. ROY MARTIN MAIN, M.D.
Title: OWNER/PHYSICIAN
Phone: (860) 536-1666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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