Individual
DR. CORY M EDGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,PHD
Contact information
Practice address
263 FARMINGTON AVE, ORTHOPAEDICS, FARMINGTON, CT 06030-4038
(860) 679-6600
(860) 679-6604
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
050405
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124294855
—
CT
Enumeration date
05/02/2008
Last updated
07/11/2022
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