Healthcare Provider Details

I. General information

NPI: 1699095224
Provider Name (Legal Business Name): VLADIMIR PAUL DAOUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2010
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 WOODLAND ST
HARTFORD CT
06105
US

IV. Provider business mailing address

95 WOODLAND ST
HARTFORD CT
06105-1230
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-6871
  • Fax: 860-714-6888
Mailing address:
  • Phone: 860-714-6871
  • Fax: 860-714-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17051
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number243996
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number055064
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: