Kismatkumar Detroja, MD
Internal Medicine in Middletown, CT. Individual provider (NPI-1).
NPI number1497774657
StatusActive
Last updated in NPPESDec 21, 2023
Details
- NPI
- 1497774657
- Entity type
- Individual (NPI-1)
- Name
- Kismatkumar Detroja
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 19, 2006
- Certification date
- Dec 20, 2023
- Last updated
- Dec 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 044462 | CT | Yes |
Practice location
1000 Silver StreetMiddletown, CT 06457
Phone 860-951-4954
Mailing address
170 Talcott Ridge RdSouth Windsor, CT 06074-2386
Phone 860-794-9160
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