| Dr Paul Allen Pudimat, MD | |
|
61 Emerald Glen Rd, Salem, CT 06420-4123 | |
| (860) 887-9053 | |
| (860) 887-9073 |
| Full Name | Dr Paul Allen Pudimat |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 61 Emerald Glen Rd, Salem, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669450102 | NPI | - | NPPES |
| 001573935 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 037393 (Connecticut) | Primary |
| Entity Name | Windham Community Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023191467 PECOS PAC ID: 2961309059 Enrollment ID: O20031217000231 |
| Entity Name | Integrated Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881636397 PECOS PAC ID: 1759281165 Enrollment ID: O20040112000163 |
| Entity Name | The William W Backus Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467517235 PECOS PAC ID: 0749170645 Enrollment ID: O20040316000739 |
| Entity Name | North American Partners In Anesthesia Connecticut Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316994775 PECOS PAC ID: 6709877939 Enrollment ID: O20040519000120 |
| Entity Name | Connecticut Gi Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023124625 PECOS PAC ID: 9830110758 Enrollment ID: O20070112000011 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Paul Allen Pudimat, MD 3998 Fair Ridge Drive, Suite 300, Fairfax, VA 22033 Ph: (703) 295-9360 | Dr Paul Allen Pudimat, MD 61 Emerald Glen Rd, Salem, CT 06420-4123 Ph: (860) 887-9053 |
Dr. Mary Ann S Pudimat, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 61 Emerald Glen Lane, Salem, CT 06420 Phone: 860-887-9073 Fax: 860-887-9073 |