Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 13579 | CT |
N | 207RP1001X | Pulmonary Disease | 13759 | CT |
NPI | 1083706170 |
---|---|
Provider Name | Carl B Sherter |
First Address | Waterbury, CT 06708 |
Second Address | Waterbury, CT 06708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 13/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1137597 | (05) | CT |
E22951 | (02) |