Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 22207 | CT |
Y | 208600000X | Surgeon | 22207 | CT |
N | 2082S0105X | Plastic Hand Surgeon | 22207 | CT |
N | 2086S0122X | Plastic and Reconstructive Surgery | 22207 | CT |
NPI | 1508800343 |
---|---|
Provider Name | Richard Sheldon Stahl |
First Address | Guilford, CT 06437-2076 |
Second Address | Guilford, CT 06437-2076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 11/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28745 | (02) | CT |