Individual
RAINER WOLF BAGDASARIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 NEWELL RD, SUITE D28, BRISTOL, CT 06010
(860) 583-2003
(860) 582-6255
Mailing address
25 NEWELL RD, SUITE D28, BRISTOL, CT 06010
(860) 583-2003
(860) 582-6255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
038365
CT
2086S0129X
Vascular Surgery Physician
038365
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001383653
—
CT
Enumeration date
08/28/2006
Last updated
03/27/2014
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