Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 023241 | CT |
NPI | 1013008317 |
---|---|
Provider Name | Louis Wang |
First Address | Middletown, CT 06457-3648 |
Second Address | Middletown, CT 06457-3648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 22/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010023241CT02 | ATHEM BCBS (01) | |
077909 | CONNECTICARE (01) | |
0V0117 | HEALTH NET (01) | |
2119762 | AETNA (01) | |
6218842006 | CIGNA (01) | |
B97503 | (02) | |
P3133385 | OXFORD (01) |