Individual
DR. GORDON E FOSDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
470 MAIN ST, MIDDLEFIELD, CT 06455-1210
(860) 349-8500
(860) 349-3081
Mailing address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1234
(860) 442-7027
(860) 444-0074
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
00723
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000723
CONNECTICARE
CT
05
—
004206951
—
CT
01
—
030000723CT05
BLUE CROSS BLUE SHIELD
CT
Enumeration date
07/15/2006
Last updated
06/26/2013
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