Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 038748 | CT |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 038748 | CT |
NPI | 1346339926 |
---|---|
Provider Name | Dr. Robert F Fitton |
First Address | Bridgeport, CT 06606-5301 |
Second Address | Bridgeport, CT 06606-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 12/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001387481 | (05) | CT |
H18939 | (02) | CT |