Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 023948 | CT |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 023948 | CT |
NPI | 1114019098 |
---|---|
Provider Name | William Gething Crawford |
First Address | New London, CT 06320-4906 |
Second Address | New London, CT 06320-4906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D77065 | (02) |