Individual
ETHAN B. FOXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 SEYMOUR ST, SUITE 200, HARTFORD, CT 06106-5501
(860) 289-3375
(860) 560-2849
Mailing address
111 FOUNDERS PLZ, SUITE 400, EAST HARTFORD, CT 06108-3212
(860) 291-6554
(860) 783-5733
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
042224
CT
2085N0700X
Neuroradiology Physician
213770
MA
2085R0202X
Diagnostic Radiology Physician
213770
MA
2085R0202X
Diagnostic Radiology Physician
42224
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001422245
—
CT
01
—
010042224CT06
ANTHEM BC/BS
CT
01
—
A2516306
OXFORD
CT
Enumeration date
12/16/2005
Last updated
01/15/2018
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