Provider Demographics
NPI:1902088446
Name:HONEYCHURCH, CAROL RUTH (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:RUTH
Last Name:HONEYCHURCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WAWARME AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-1509
Mailing Address - Country:US
Mailing Address - Phone:860-466-6274
Mailing Address - Fax:
Practice Address - Street 1:309 WAWARME AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1509
Practice Address - Country:US
Practice Address - Phone:860-466-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0217552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology