Individual
DAVID FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 RETREAT AVE, SUITE 903, HARTFORD, CT 06106-2528
(860) 244-0148
(860) 240-7063
Mailing address
PO BOX 587, ROCKY HILL, CT 06067-0587
(860) 258-3480
(860) 571-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
041531
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
41531
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06144079005
—
CT
Enumeration date
09/14/2006
Last updated
11/15/2022
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