Individual
DR. ALFREDO LUIS AXTMAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8 RESEARCH PKWY, WALLINGFORD, CT 06492-1929
(203) 265-9122
(203) 265-9159
Mailing address
8 RESEARCH PKWY, WALLINGFORD, CT 06492-1929
(203) 265-9122
(203) 265-9159
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
022215
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004239176
—
CT
01
—
0045604
AETNA ID #
CT
01
—
010022215CT07
ANTHEM ID #
CT
01
—
2V3535
HEALTHNET ID #
CT
01
—
783182
CONNECTICARE ID #
CT
01
—
P1279064
OXFORD ID #
CT
Enumeration date
11/15/2005
Last updated
03/30/2011
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