Provider Demographics
NPI:1477508778
Name:BLATTMAN, SETH BARAK (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:BARAK
Last Name:BLATTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:501 KINGS HWY E
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4867
Mailing Address - Country:US
Mailing Address - Phone:203-382-1900
Mailing Address - Fax:203-382-0019
Practice Address - Street 1:501 KINGS HWY E
Practice Address - Street 2:SUITE 112
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-4867
Practice Address - Country:US
Practice Address - Phone:203-382-1900
Practice Address - Fax:203-382-0019
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2199092086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001443324Medicaid