Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 027669 | CT |
N | 2082S0105X | Plastic Hand Surgeon | 72702 | MA |
N | 2086S0105X | Surgery of the Hand | 027669 | CT |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 027669 | CT |
NPI | 1922117787 |
---|---|
Provider Name | Dr. Duffield Ashmead IV |
First Address | Glastonbury, CT 06033-1208 |
Second Address | Glastonbury, CT 06033-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 10/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001276692 | (05) | CT |
B39208 | (02) | CT |