Provider Demographics
NPI:1184688376
Name:WETMORE, ROBERT SATTERLEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SATTERLEE
Last Name:WETMORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 STRAITS TPKE
Mailing Address - Street 2:STE E1
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1835
Mailing Address - Country:US
Mailing Address - Phone:203-758-1760
Mailing Address - Fax:203-758-8838
Practice Address - Street 1:133 SCOVILL ST STE 308
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1127
Practice Address - Country:US
Practice Address - Phone:203-709-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023619174400000X
CT23619207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT03-69411OtherAMERICHOICE
CT010023619CT04OtherANTHEM BCBS CT
CT2V7019OtherHEALTHNET/COMMERCIAL
CTP3715679OtherOXFORD
CTPENDINGOtherRR MEDICARE
CT1066903OtherUSA
CT1427808/4226785OtherAETNA
CT419532OtherWELLCARE
CT03-69411OtherUHC
CT001236199Medicaid
CT023619OtherCONNECTICARE
CT200001140Medicare PIN
CT001236199Medicaid