Individual
KENNETH WAYNE DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 SAYBROOK RD, UNIT 6, ESSEX, CT 06426-1490
(860) 358-3725
(860) 358-3726
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6000
(860) 358-8661
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042916
CT
207R00000X
Internal Medicine Physician
MD12478
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001429168
—
CT
Enumeration date
02/17/2006
Last updated
12/11/2025
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