Provider Demographics
NPI:1659476158
Name:HUVELLE, PETER RINEHART (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:RINEHART
Last Name:HUVELLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2 CHURCH ST SOUTH
Mailing Address - Street 2:SUITE 508
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519
Mailing Address - Country:US
Mailing Address - Phone:203-752-1101
Mailing Address - Fax:203-752-0645
Practice Address - Street 1:2 CHURCH ST S
Practice Address - Street 2:SUITE 508
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1717
Practice Address - Country:US
Practice Address - Phone:203-752-1101
Practice Address - Fax:203-752-0645
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT18256207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1182568Medicaid
CT1182568Medicaid
D83233Medicare UPIN