Fergus Dane John Lane MD

NPI 1043456064 - Anesthesiology - 207L00000X

NPI Details
NPI 1043456064
Gender Male
Enumeration Date 12/22/2008
Last Updated 12/22/2008
Entity Type Individual
Active Over 7 years ago
Practice Location
350 FERN HILL ROAD
BRISTOL CT, 06010, US
Phone (860) 583-7851
Fax
Business Location
350 FERN HILL ROAD
BRISTOL CT, 06010-3180, US
Phone
Fax
Toxanomy
Taxonomy Code 207L00000X
License State Connecticut
License Number 019701
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According to our database, Dr. Fergus Dane John Lane MD NPI is 1043456064, taxonomy code is 207L00000X and license number is 019701, license state is located at Connecticut. Fergus Dane John Lane MD physically located at 350 Fern Hill Road, Bristol CT, 06010. NPI Number Fergus Dane John Lane MD has the Individual type.

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1043456064 NPI number is provided on an as is basis without warranty of any kind. 1043456064 is maintained by the National Plan & Provider Enumeration System. The contents of Fergus Dane John Lane MD are for informational purposes only.