Provider Demographics
NPI:1619940327
Name:PODELL, DAVID N (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:PODELL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1805
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:64 ROBBINS ST
Practice Address - Street 2:RHEUMATOLOGY, THIRD FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2613
Practice Address - Country:US
Practice Address - Phone:203-573-7281
Practice Address - Fax:203-573-7230
Is Sole Proprietor?:No
Enumeration Date:2006-02-12
Last Update Date:2021-03-10
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Provider Licenses
StateLicense IDTaxonomies
CT023789207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001237890Medicaid