Provider Demographics
NPI:1689665853
Name:FRITZ, JAMES JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:FRITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:ROUTE 12 BLDG 449
Mailing Address - Street 2:ATTN PROFESSIONAL AFFAIRS NAVAL AMBULATORY CARE CENTER
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06349-5600
Mailing Address - Country:US
Mailing Address - Phone:860-694-2377
Mailing Address - Fax:860-694-2590
Practice Address - Street 1:RT 12 BLDG 449
Practice Address - Street 2:ATTN PROFESSIONAL AFFAIRS NAVAL AMBULATORY CARE CENTER
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349-5600
Practice Address - Country:US
Practice Address - Phone:860-694-2377
Practice Address - Fax:860-694-2590
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT028309208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN