Dr. Genevieve Montagu Von Walstrom
General Practice Physician Obstetrician & Gynecologist Internist - Addiction Medicine
17 Wall St
Madison
, Connecticut 06443-3122
Dr. Genevieve Montagu Von Walstrom
General Practice Physician Obstetrician & Gynecologist Internist - Addiction Medicine
17 Wall St
Madison
, Connecticut 06443-3122
(203) 554-8803
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About
Features
Specialties
- Internist - Addiction Medicine
- Obstetrician & Gynecologist
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Genevieve Montagu Von Walstrom
- 2310 Bigelow Cmns
- Enfield, CT
- Zip : 06082-3342
- Phone : (203) 554-8803
Second Address
- Dr. Genevieve Montagu Von Walstrom
- 17 Wall St
- Madison, CT
- Zip : 06443-3122
- Fax : (203) 245-0572
- Phone : (203) 779-5126
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Is Dr. Genevieve Montagu Von Walstrom accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RA0401X | Internist - Addiction Medicine | 57243 | CT |
| N | 207V00000X | Obstetrician & Gynecologist | 57243 | CT |
| Y | 208D00000X | General Practice Physician | 57243 | CT |
National Provider Identifier
| NPI | 1962797696 |
|---|---|
| Provider Name | Dr. Genevieve Montagu Von Walstrom |
| First Address | Enfield, CT 06082-3342 |
| Second Address | Madison, CT 06443-3122 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/06/2011 |
| Last Update Date | 04/02/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.