Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 039210 | CT |
Y | 208600000X | Surgeon | 039210 | CT |
N | 2086S0129X | Vascular Surgeon | 039210 | CT |
N | 2086X0206X | Surgical Oncologist | 039210 | CT |
NPI | 1104824788 |
---|---|
Provider Name | Dr. Edward J. White |
First Address | Ludlow, MA 01056-0789 |
Second Address | Enfield, CT 06082-4571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 31/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001392109 | (05) | CT |
00139210900 | BLUE CARE FAMILY PLAN (01) | CT |
010039210CT01 | ANTHEM BCBS (01) | CT |
039210 | CONNECTICARE (01) | CT |
206898 | PREFERRED ONE (01) | CT |
2991329 | AETNA PROVIDER NUMBER (01) | CT |
2V2766 | HEALTH NET (01) | CT |
611419998 | CIGNA PROVIDER NUMBER (01) | CT |
611419998 | COMMUNITY HEALTH NETWORK (01) | CT |
611419998 | FIRST HEALTH (01) | CT |
611419998 | NORTHEAST HEALTH DIRECT (01) | CT |
611419998 | PHCS (01) | CT |
611419998 | PIONEER HEALTH CARE (01) | CT |
611419998 | TRICARE (01) | CT |
611419998 | UNITED HEALTHCARE (01) | CT |
A40558 | (02) | CT |
P2718117 | OXFORD PROVIDER NUMBER (01) | CT |