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-- KEVIN O DIECKHAUS -- MD

Individual Provider (NPI-1) Active

Internal Medicine, Infectious Disease

Provider Information

NPI Number
1316942378
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
263 FARMINGTON AVE, FARMINGTON, CT, 060300001
Phone
(860) 679-4225
Fax
(860) 679-1217

Specialties & Taxonomies

Internal Medicine, Infectious Disease Primary License: CT #035297

All Addresses

LOCATION

263 FARMINGTON AVE

FARMINGTON, CT, 060300001

(860) 679-4225

MAILING

263 FARMINGTON AVE PROVIDER ENROLLMENT

FARMINGTON, CT, 060302212

(860) 679-7503