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Individual

DR. KEITH M LEMIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
741 BROAD ST EXT, WATERFORD, CT 06385
(860) 442-5663
(860) 444-7778
Mailing address
741 BROAD ST EXT, WATERFORD, CT 06385
(860) 442-5663
(860) 444-7778

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
002391
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410045811
RR MEDICARE
CT
Enumeration date
05/01/2006
Last updated
10/26/2010
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