Individual
DR. GLEN DANIEL BLOMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
56 FRANKLIN ST, SAINT MARY'S HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE, WATERBURY, CT 06706-1253
(203) 709-6004
(203) 709-3710
Mailing address
56 FRANKLIN ST, SAINT MARY'S HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE, WATERBURY, CT 06706-1253
(203) 709-6004
(203) 709-3710
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
051665
CT
Other
Enumeration date
07/03/2009
Last updated
11/11/2021
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