Individual
SERAG DREDAR
Active
Individual
SERAG DREDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049962
CT
207RG0100X
Gastroenterology Physician
49962
CT
207RG0100X
Gastroenterology Physician
Primary
A121430
CA
208M00000X
Hospitalist Physician
049962
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0022640
INSTITUTIONAL PERMIT
—
Enumeration date
05/21/2007
Last updated
07/10/2015
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