Provider Demographics
NPI:1871698829
Name:DRUCKEMILLER, WILLIAM H JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:DRUCKEMILLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 605
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-246-1636
Mailing Address - Fax:860-522-3119
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 605
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-246-1636
Practice Address - Fax:860-522-3119
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT022597207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
140000060Medicare ID - Type Unspecified
B83733Medicare UPIN