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Individual

MR. HENRY F FEDUS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501
Mailing address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0662
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000662
PODIATRIST LICENSE
CT
01
25027
CONTROLLED SUBSTANCE
CT
Enumeration date
04/20/2006
Last updated
07/08/2007
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