Individual
DR. TERRY BAKSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 LATHROP AVE, NORWICH, CT 06360-2309
(860) 204-0883
Mailing address
2 LATHROP AVE, NORWICH, CT 06360-2309
(860) 204-0883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
037796
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001377961
—
CT
Enumeration date
12/14/2005
Last updated
05/27/2022
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