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Individual

ROBERT M BEDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
836 FARMINGTON AVENUE, SUITE 207, WEST HARTFORD, CT 06119-1505
(860) 232-9911
(860) 233-5996
Mailing address
836 FARMINGTON AVENUE, SUITE 207, WEST HARTFORD, CT 06119
(860) 232-9911
(860) 233-5996

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
025672
CT
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
025672
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001256726
CT
01
00125672600
BLUE CROSS MEDICAID
01
004394508
MEDICAID GROUP CAAC
01
010025672CT01
BLUE CROSS
01
0127519002
CIGNA
01
051077
CONNECTICARE
01
226295
PREFERRED ONE
01
OS2044
HEALTHNET MEDICAID
01
P2191290
OXFORD
Enumeration date
11/09/2005
Last updated
02/04/2010
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