Individual
C WALLACE ANDRIAS
Active
Individual
C WALLACE ANDRIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20133
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001201334
BLUECARE FAMILY PLAN
—
05
—
001201334
—
CT
01
—
010020133CT02
ANTHEM/ECCG:06-1049086
—
01
—
010020133CT06
ANTHEM/ECCD:06-1616101
—
01
—
020133
CONNECTICARE
—
01
—
030265
HEALTHNET/ECCG:06-1049086
—
01
—
060014262
RR MED/ECCG: 06-1049086
—
01
—
060064826
RR MED/ECCD: 06-1616101
—
01
—
0V9740
HEALTHNET/ECCD:06-1616101
—
01
—
500HBC444CT01
ANTHEM/HOSP-BASED ECCD
—
01
—
NLS101
OXFORD/ECCG: 06-1049086
—
01
—
P2524339
OXFORD/ECCD: 06-1616101
—
Enumeration date
05/18/2006
Last updated
07/21/2022
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