Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 042312 | CT |
NPI | 1023092459 |
---|---|
Provider Name | Dieter M Lindskog |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 26/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001423128 | (05) | CT |
I12271 | (02) |