Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 037360 | CT |
NPI | 1043288061 |
---|---|
Provider Name | Dr. Gail B. Whitman |
First Address | Stratford, CT 06614-4980 |
Second Address | Stratford, CT 06614-4980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A14207 | (02) | CT |