Individual
DR. DONNA JOAN HAGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
31 RIVER RD, SUITE 102, COS COB, CT 06807-2152
(203) 742-1150
(203) 489-3411
Mailing address
31 RIVER RD, SUITE 102, COS COB, CT 06807-2152
(203) 742-1150
(203) 489-3411
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010032695CT05
ANTHEM BLUE CROSS CT NUMB
CT
Enumeration date
03/01/2007
Last updated
01/15/2014
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