Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 64711 | CT |
N | 2086S0127X | Trauma Surgeon | 64711 | CT |
NPI | 1083931166 |
---|---|
Provider Name | Heath Walden |
First Address | Danbury, CT 06810-6099 |
Second Address | Danbury, CT 06810-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2010 |
Last Update Date | 15/01/2020 |