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NPI Code Detail

MEDICARE: WAHILA ALAM M.D.

MEDICARE: WAHILA ALAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2009-01180NC
2208D00000XGeneral Practice Physician2009-01180NC
3207QG0300XGeriatric Medicine (Family Medicine) Physician056905CT

General Provider Information

NPI Number : 1215128202
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAHILA ALAM M.D.
Provider Business Mailing Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4477
Fax Number : 860-679-8770
Provider Business Practice Location Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4477
Fax Number : 860-679-8770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 07/11/2022

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Directions to “ WAHILA ALAM M.D.” Practice Location

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