NPI 1619107810

Michael E Bidwell, ATCL

Practitioner Specialist Manchester, CT

Practice location

Address: 586 E Middle Tpke, Manchester, CT 06040-3730
Phone: (860) 645-3810

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 000343 (CT)

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Registry record

NPI: 1619107810
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jul 2009
Record last updated: 22 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.