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General NPI Number Information
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NPI Number | 1508887290
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Entity Type | Individual
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Provider Name | MURRAY ISAAC WELLNER MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 10 DALE ST
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1815
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Country | US
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Telephone | 860-521-9451
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Fax | 860-232-2793
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Provider Business Mailing Address
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Address Line | 10 DALE ST
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1815
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Country | US
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Telephone | 860-521-9451
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Fax | 860-232-2793
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18806
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License Number State | CT
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