Donald Maxwell, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

026642 Issued in CT

Practice address

421 Cottage Grove Rd
Suite B
Bloomfield, CT 06002-3119

Phone

(860) 242-0034

Fax

(860) 242-3301

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1740235282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 COTTAGE GROVE RD",
            "address_2": "SUITE B",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023119",
            "telephone_number": "860-242-0034",
            "fax_number": "860-242-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 COTTAGE GROVE RD",
            "address_2": "SUITE B",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023119",
            "telephone_number": "860-242-0034",
            "fax_number": "860-242-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "026642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001266429",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bloomfield, CT
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.