Provider Demographics
NPI:1760483093
Name:CAMBRIDGE, WILLIAM ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:CAMBRIDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 1/2 CASE ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2223
Mailing Address - Country:US
Mailing Address - Phone:860-886-8345
Mailing Address - Fax:860-886-4251
Practice Address - Street 1:28 1/2 CASE ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2215
Practice Address - Country:US
Practice Address - Phone:860-886-8345
Practice Address - Fax:860-886-4251
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2013-04-11
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2007-10-22
Provider Licenses
StateLicense IDTaxonomies
CT023709207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001237098Medicaid
CT010023709CT01OtherANTHEM BCBS ID NUMBER
CTNLP012OtherOXFORD ID
CT506137OtherAETNA ID
CT030918OtherHEALTHNET ID
CTNLP012OtherOXFORD ID
CTB83299Medicare UPINUPIN