Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 024376 | CT |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 024376 | CT |
NPI | 1285662627 |
---|---|
Provider Name | Dr. Thomas C Cherry JR. |
First Address | Norwich, CT 06360-2737 |
Second Address | Norwich, CT 06360-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 22/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0080123210 | (05) | CT |
010024376CT01 | ANTHEM (01) | CT |
3V6188 | HEALTHNET (01) | CT |
P4093027 | OXFORD (01) | CT |