Individual
DR. HENRY RANDALL MARESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 HIGH ST, FARMINGTON, CT 06032
(860) 677-2017
(860) 674-0878
Mailing address
2 HIGH ST, FARMINGTON, CT 06032
(860) 677-2017
(860) 674-0878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017150
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010017150CT01
ANTHEM
—
01
—
017150
CONNECTICARE
—
01
—
060986657001
CIGNA
—
01
—
OV4711
HEALTHNET
—
01
—
P601065
OXFORD
—
Enumeration date
07/12/2006
Last updated
07/08/2007
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