Provider Demographics
NPI:1770586471
Name:FRAM, DANIEL BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRUCE
Last Name:FRAM
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 1:85 SEYMOUR ST
Mailing Address - Street 2:STE 821
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5527
Mailing Address - Country:US
Mailing Address - Phone:860-545-5061
Mailing Address - Fax:860-545-3558
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:STE 821
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-545-5061
Practice Address - Fax:860-545-3558
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029979207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060000930Medicare ID - Type Unspecified
CTE81178Medicare UPIN