Individual
DR. ANIL K VITHALA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
477 CONNECTICUT BLVD, SUITE 112, EAST HARTFORD, CT 06108-3268
(860) 289-0623
Mailing address
477 CONNECTICUT BLVD, SUITE 112, EAST HARTFORD, CT 06108-3268
(860) 289-0623
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
034801
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010034801CT01
ANTHEM
CT
01
—
01034801
CIGNA
—
Enumeration date
10/04/2005
Last updated
07/08/2007
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