Healthcare Provider Details

I. General information

NPI: 1467646166
Provider Name (Legal Business Name): EDGAR R NAUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST DEPT OF MEDICINE
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

114 WOODLAND ST DEPT OF MED
HARTFORD CT
06105-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-7446
  • Fax: 806-714-1508
Mailing address:
  • Phone: 860-714-7446
  • Fax: 806-714-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number047115
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: