Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mystic Medical Group, PC

Organization Internal Medicine Physician · NPI 1902891070

Mystic Medical Group, PC is an Internal Medicine Physician in Mystic, Connecticut. Registered with an NPI since 2005.

In the registry since
2005
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 Sandy Hollow Rd
Mystic, CT 06355-1720
Phone: (860) 572-8911
Fax: (860) 572-7758
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1902891070
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Blum — President · (860) 572-8911
NPI enumeratedSeptember 15, 2005
Last updated in NPPESDecember 22, 2009
Mailing address200 Sandy Hollow Rd, Mystic, CT 06355-1720

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