Provider Demographics
NPI:1891705315
Name:FLITCRAFT, ANNE H (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:H
Last Name:FLITCRAFT
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:131 COVENTRY STREET
Mailing Address - Street 2:BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112
Mailing Address - Country:US
Mailing Address - Phone:860-714-3690
Mailing Address - Fax:860-714-8683
Practice Address - Street 1:131 COVENTRY STREET
Practice Address - Street 2:BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112
Practice Address - Country:US
Practice Address - Phone:860-714-3690
Practice Address - Fax:860-714-8683
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026794204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001267947Medicaid
CT10447314OtherCAQH ID #
CT001267947Medicaid