Emmanuel Estavillo Bautista, MD Valid NPI
Individual provider · Family Medicine Physician · Bridgeport, CT
- NPI
- 1902965106
- Type
- Individual (Type 1)
- Primary specialty
- Family Medicine Physician (Family Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207Q00000X
- License number
- 025021 (CT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-12-06
- Last updated
- 2007-07-08
Practice location
Southwest Ct Mental Health System Attn Sandra Grazynski, 1635 Central Avenue Room 213
Bridgeport, CT 06610
(203) 551-7660