Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 027293 | CT |
NPI | 1013935592 |
---|---|
Provider Name | Steven Bruce Carlow |
First Address | Groton, CT 06340-6228 |
Second Address | Groton, CT 06340-6228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 18/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D02606 | (02) | CT |