Individual
DR. LATESHA I DAWSON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
99 ASH ST, UCONN MEDICAL GROUP-PEDIATRICS, EAST HARTFORD, CT 06108-3226
(860) 282-3859
(860) 282-8574
Mailing address
264 FARMINGTON AVENUE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
046993
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497925044
—
CT
Enumeration date
03/10/2008
Last updated
11/18/2022
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