Individual
LESLIE J FODEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 HILLSPOINT RD, WESTPORT, CT 06880-4536
(203) 226-3411
(203) 226-3411
Mailing address
12 HILLSPOINT RD, WESTPORT, CT 06880-4536
(203) 226-3411
(203) 226-3411
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
12646
CT
207R00000X
Internal Medicine Physician
Primary
12646
CT
Other
Enumeration date
05/26/2014
Last updated
05/27/2014
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