Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 036147663 | IL |
Y | 204F00000X | Transplant Surgeon | 064803 | CT |
NPI | 1821084211 |
---|---|
Provider Name | Glyn Morgan |
First Address | Wethersfield, CT 06109-4337 |
Second Address | Hartford, CT 06106-5522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 26/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064803 | CT LICENSE (01) | CT |
G72268 | (02) | NY |