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BASSAM AWWA MD

Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1881774354

Individual Registrant:
 BASSAM  AWWA MD
Gender: M
Sole Proprietor

Location and contact information for practice:
41 FAIR HARBOUR PL  NEW LONDON, CT 06320-4710 US
Tel: 860-437-6914  Fax: 860-437-6920

Contact information for business:
41 FAIR HARBOUR PL  NEW LONDON, CT 06320-4710 US
Tel: 860-437-6914  Fax: 860-437-6921

Registration Information:
NPI: 1881774354
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
Psychiatry
CT24399
Y2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
CT024399

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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