Provider Demographics
NPI:1750378253
Name:WINDELS, MARY HYDE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:HYDE
Last Name:WINDELS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:STE 409
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-522-4158
Mailing Address - Fax:860-524-2652
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:STE 409
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-522-4158
Practice Address - Fax:860-524-2652
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0363132086S0129X, 2085R0204X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT06-1406459OtherUNITED HEALTHCARE
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEM
CTP2392697OtherOXFORD
CT010036313CT02OtherANTHEM BCBS
MA0124362Medicaid
CT787894OtherCONNECTICARE
CT001363134Medicaid
CT06-1406459OtherCORVEL
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
CT06-1406459OtherHMC, PPO
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT0647581 004OtherCIGNA
CT23790OtherHEALTH NEW ENGLAND
CT06-1406459OtherFOCUS
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherGREAT WEST HEALTHCARE
CT0V6081OtherHEALTH NET
CT2014538OtherAETNA
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT0V6081OtherHEALTH NET