Individual
DR. MARK DZIEDZIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-2000
Mailing address
80 SEYMOUR ST., CONKLILN BUILDING RM 114, HARTFORD, CT 06102-5037
(860) 545-1448
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
046089
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/09/2007
Last updated
07/18/2008
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