Provider Demographics
NPI:1639164775
Name:VERSLAND, MARK R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:VERSLAND
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2139 SILAS DEANE HIGHWAY
Mailing Address - Street 2:CONNECTICUT GI, PC
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1327
Mailing Address - Country:US
Mailing Address - Phone:860-257-4131
Mailing Address - Fax:860-257-4519
Practice Address - Street 1:1 LIBERTY SQUARE FLOOR 2
Practice Address - Street 2:CONNECTICUT GI, PC
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2637
Practice Address - Country:US
Practice Address - Phone:860-229-9688
Practice Address - Fax:860-229-5498
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2014-01-24
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Provider Licenses
StateLicense IDTaxonomies
CT028335207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0925918002OtherCIGNA
CT744458OtherCONNECTICARE
CT0076300OtherAETNA
CT001283358Medicaid
CTHAS486OtherOXFORD
CT010028335CT01OtherANTHEM BC
CT001283358Medicaid
CT010028335CT01OtherANTHEM BC