Individual
DR. LAWRENCE J. FORTIER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
465 SILAS DEANE HWY, WETHERSFIELD, CT 06109-2134
(860) 529-2500
(860) 529-6899
Mailing address
465 SILAS DEANE HWY, WETHERSFIELD, CT 06109-2134
(860) 529-2500
(860) 529-6899
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
025854
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001258540
—
CT
01
—
010025854CT01
ANTHEM BC/BS
CT
Enumeration date
10/13/2005
Last updated
03/15/2017
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