Davignon, Marc Bertrand

Davignon, Marc Bertrand is an individual health care provider with primary practice located at 111 Founders Plz Suite 400, East Hartford CT 06108-3212. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Nuclear Medicine is his primary health care specialty. Davignon, Marc Bertrand can be contacted via phone (860) 246-6589.

Contact Information

Primary practice address
111 Founders Plz Suite 400 East Hartford CT 06108-3212
Phone: (860) 246-6589
Fax: (860) 528-0778
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X 022073 Connecticut
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 022073 Connecticut

Profile Details

NPI number 1093816118
LBN Legal business name Davignon, Marc Bertrand
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 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 1093816118 NPPES
Connecticut MEDICAID 4097392

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