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BALASUBRAMANIAN SHANMUGAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
923 FARMINGTON AVE, BRISTOL, CT 06010-3927
(860) 314-6000
(860) 614-6005
Mailing address
PO BOX 2828, BRISTOL, CT 06011-2828
(860) 585-3906
(860) 585-3907

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
046167
CT
207RI0200X
Infectious Disease Physician
046167
CT

Other

Enumeration date
04/07/2008
Last updated
02/22/2011
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