Organization
NORWICH INFECTIOUS DISEASE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J RAJKUMAR MD (PRESIDENT)
(860) 886-8545
Entity
Organization
Contact information
Practice address
112 LAFAYETTE ST, NORWICH, CT 06360-2737
(860) 886-8545
(855) 629-7856
Mailing address
112 LAFAYETTE ST, NORWICH, CT 06360-2737
(860) 886-8545
(855) 629-7856
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
I17254
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001386607
—
CT
01
—
010038660CT02
ANTHEM
CT
01
—
1730332313
AETNA
CT
01
—
9621008
CIGNA
CT
Enumeration date
10/28/2008
Last updated
10/03/2014
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