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Individual

MICHAEL E BLEFELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
495 GOLD STAR HWY, SUITE 120, GROTON, CT 06340-6228
(860) 449-8882
(860) 449-9195
Mailing address
495 GOLD STAR HWY, SUITE 120, GROTON, CT 06340-6228
(860) 449-8882
(860) 449-9195

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22070
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001220706
CT
01
010022070CT01
BLUE CROSS BLUE SHIELD
01
031502
HEALTH NET
01
1416771-005
CIGNA
01
4205040
AETNA
01
620293
CONNECTICARE
01
NLP064
OXFORD
Enumeration date
11/13/2006
Last updated
12/29/2008
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