Individual
GEORGE DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 HAZARD AVE, ENFIELD, CT 06082-4575
(860) 763-1043
(860) 749-1459
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
018114
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001181148
—
CT
01
—
01008114CT01
BCBS
CT
01
—
018114
MEDICAL LICENSE
CT
Enumeration date
12/23/2005
Last updated
03/07/2023
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