Andrias, C Wallace

Andrias, C Wallace is an individual health care provider with primary practice located at 235 Lestertown Rd , Groton CT 06340-2808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Andrias, C Wallace can be contacted via phone (860) 822-3547.

Contact Information

Primary practice address
235 Lestertown Rd Groton CT 06340-2808
Phone: (860) 822-3547
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 20133 Connecticut

Profile Details

NPI number 1598718876
LBN Legal business name Andrias, C Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jul 21st, 2022 - about 2 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 1598718876 NPPES
Other 060014262 RR MED/ECCG: 06-1049086
Other 500HBC444CT01 RR MED/ECCG: 06-1049086
Other 0V9740 RR MED/ECCG: 06-1049086
Other NLS101 RR MED/ECCG: 06-1049086
Other 001201334 RR MED/ECCG: 06-1049086
Other 030265 RR MED/ECCG: 06-1049086
MEDICAID 001201334 RR MED/ECCG: 06-1049086
Other 010020133CT02 RR MED/ECCG: 06-1049086
Other 060064826 RR MED/ECCG: 06-1049086
Other P2524339 RR MED/ECCG: 06-1049086
Other 010020133CT06 RR MED/ECCG: 06-1049086
Other 020133 RR MED/ECCG: 06-1049086

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