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Individual

DR. STUART M DEGLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
164 OTROBANDO AVE, NORWICH, CT 06360-2116
(860) 886-0023
(860) 886-0024
Mailing address
164 OTROBANDO AVE, NORWICH, CT 06360-2116
(860) 886-0023
(860) 886-0024

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
017694
CT
207RC0000X
Cardiovascular Disease Physician
Primary
17694
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0100017694CT03
ANTHEM BCBS
01
2V7779
HEALTHNET
Enumeration date
08/31/2006
Last updated
08/04/2015
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