Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 35092796 | OH |
NPI | 1083739700 |
---|---|
Provider Name | Dr. Chad Edward Connor |
First Address | Wright Patterson Afb, OH 45433-5529 |
Second Address | Wright Patterson Afb, OH 45433-5546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 20/04/2018 |