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Individual

DR. ANDREW ERVIN WAKEFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
360 BLOOMFIELD AVE, SUITE 209, WINDSOR, CT 06095-2700
(860) 688-1311
(860) 687-1319
Mailing address
360 BLOOMFIELD AVE, SUITE 209, WINDSOR, CT 06095-2700
(860) 688-1311
(860) 687-1319

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
037617
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001376179
CT
Enumeration date
08/11/2006
Last updated
03/11/2009
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