MEDICARE: DR. ANDREW ERVIN WAKEFIELD 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
1	207T00000X	Neurological Surgery Physician	037617	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407867708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW ERVIN WAKEFIELD M.D.

Provider Business Mailing Address
First Line	:	360 BLOOMFIELD AVE
Second Line	:	SUITE 209
City	:	WINDSOR
State	:	CT
Zip	:	06095-2700
Country	:	US
Telephone Number	:	860-688-1311
Fax Number	:	860-687-1319

Provider Business Practice Location Address
First Line	:	360 BLOOMFIELD AVE
Second Line	:	SUITE 209
City	:	WINDSOR
State	:	CT
Zip	:	06095-2700
Country	:	US
Telephone Number	:	860-688-1311
Fax Number	:	860-687-1319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	03/11/2009

Similar Medicare Providers

1174461065 — AALIYAH ENGRAM
Practice Location Address:

360 BLOOMFIELD AVE STE 301
WINDSOR, CT
06095-2700

Practice Phone: 888-880-9270
Practice Fax: 866-500-2186

1992653455 — JAHSHUA HOLMES
Practice Location Address:

360 BLOOMFIELD AVE STE 301
WINDSOR, CT
06095-2700

Practice Phone: 877-418-2978
Practice Fax:

1609413772 — ERYKAH MORGAN
Practice Location Address:

360 BLOOMFIELD AVE STE 301
WINDSOR, CT
06095-2700

Practice Phone: 888-880-9244
Practice Fax:

1578410395 — NIZA MARIE SOTO COSTELLO
Practice Location Address:

360 BLOOMFIELD AVE STE 301
WINDSOR, CT
06095-2700

Practice Phone: 888-880-9270
Practice Fax:

1255342556 — SEAN TIMOTHY BRENNAN PA-C
Practice Location Address:

360 BLOOMFIELD AVE , SUITE 209
WINDSOR, CT
06095-2700

Practice Phone: 860-688-1311
Practice Fax: 860-687-1319

1558524298 — SAINT FRANCIS GI ENDOSCOPY L.L.C
Practice Location Address:

360 BLOOMFIELD AVE , SUITE 204
WINDSOR, CT
06095-2700

Practice Phone: 561-330-3381
Practice Fax: 561-330-3382

Directions to “ DR. ANDREW ERVIN WAKEFIELD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.