Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 7749 | CT |
N | 213EG0000X | General Practice | 7749 | CT |
Y | 1223P0700X | Prosthodontist | 7749 | CT |
NPI | 1235132226 |
---|---|
Provider Name | Dr. Edward David Paul |
First Address | Norwalk, CT 06851-5710 |
Second Address | Norwalk, CT 06851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 08/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7749 | LICENSE NUMBER (01) | CT |