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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
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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