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Individual

DR. HUSAM BAHGAT SHITIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
430 HIGHLAND AVE, CHESHIRE, CT 06410-2562
(203) 271-3132
(203) 271-3940
Mailing address
430 HIGHLAND AVE, CHESHIRE, CT 06410-2562
(203) 271-3132
(203) 271-3940

Taxonomy

Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
034996
CT
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
ME 72340
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010034996CT01
ANTHEM BLUE CROSS
CT
01
0V0544
HEALTHNET
CT
01
110134996CT01
RAIL ROAD MEDICARE
CT
01
619002
AETNA
CT
01
718079
CONNECTICARE
CT
01
G29889
UNITED HEALTH CARE
CT
Enumeration date
09/26/2006
Last updated
07/08/2007
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