Provider Information for 1215128202
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WAHILA ALAM M.D.
Sex: Female
NPI: 1215128202
Last Updated: 2022-07-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1215128202 | ||||||||||||||||
| Enumeration Date | 2007-08-06 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-8082 United States Phone: 860-679-4477 | Fax:860-679-8770 | ||||||||||||||||
| Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-8082 United States Phone: 860-679-4477 | Fax:860-679-8770 | ||||||||||||||||
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