Individual
DR. ROBERT W. ELWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 MASONIC AVE., 1ST FLR, WALLINGFORD, CT 06492
(203) 679-5900
(203) 679-6873
Mailing address
22 MASONIC AVE., 1ST FLOOR, WALLINGFORD, CT 06492
(203) 679-5900
(203) 679-6873
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21753
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010021753CT01
ANTHEM BC OF CT
CT
01
—
021753
CONNECTICARE
CT
01
—
061043813002
CIGNA
CT
05
—
1217538
—
CT
01
—
4239676
AETNA
CT
01
—
OR4598
HEALTH NET
CT
01
—
P400371
OXFORD
CT
Enumeration date
09/28/2005
Last updated
01/20/2010
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