Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 57115 | CT |
NPI | 1144514522 |
---|---|
Provider Name | Dr. Adam Quinn Ferguson |
First Address | Wallingford, CT 06492-2434 |
Second Address | Wallingford, CT 06492-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2011 |
Last Update Date | 02/03/2020 |