Provider Demographics
NPI:1891751228
Name:ST PIERRE, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ST PIERRE
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 1:1 LIBERTY SQUARE
Mailing Address - Street 2:STE 1
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051
Mailing Address - Country:US
Mailing Address - Phone:860-229-6811
Mailing Address - Fax:860-224-8088
Practice Address - Street 1:1 LIBERTY SQUARE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051
Practice Address - Country:US
Practice Address - Phone:860-229-6811
Practice Address - Fax:860-224-8088
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038859207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001388596Medicaid
CT720930OtherCTCARE
CT50LEXINGTCT01OtherANTHEM
CT001388596Medicaid
CT50LEXINGTCT01OtherANTHEM