Individual
LEWIS M BADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2660 MAIN ST, SUITE 103, BRIDGEPORT, CT 06606-5369
(203) 683-4540
(203) 926-1415
Mailing address
PO BOX 6128, BRIDGEPORT, CT 06606-0128
(203) 683-4500
(203) 926-1410
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
015987
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001159870
—
CT
Enumeration date
06/24/2005
Last updated
01/07/2013
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