Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 67310 | CT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 67310 | CT |
NPI | 1427410893 |
---|---|
Provider Name | Erik Mcdonald |
First Address | New Haven, CT 06510-3220 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 19/07/2021 |