Provider Demographics
NPI:1811921356
Name:MARON, WILLIAM R (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:MARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:21 WOODLAND ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-4318
Mailing Address - Country:US
Mailing Address - Phone:860-522-5215
Mailing Address - Fax:860-247-3347
Practice Address - Street 1:21 WOODLAND ST
Practice Address - Street 2:SUITE 222
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4318
Practice Address - Country:US
Practice Address - Phone:860-522-5215
Practice Address - Fax:860-247-3347
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT018676207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010018676CT01OtherBLUE CROSS BLUE SHIELD
CT0230240001Medicare NSC
CT010018676CT01OtherBLUE CROSS BLUE SHIELD
CTB39482Medicare UPIN