Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD14391 | DC |
NPI | 1003835034 |
---|---|
Provider Name | Wilton O R Nedd |
First Address | Washington, DC 20017-2107 |
Second Address | Washington, DC 20017-2107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 07/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001 | BLUE CROSS BLUE SHIELD (01) | |
026569100 | (05) | DC |
12902 | CHARTERED HEALTH PLAN (01) | |
4835 | ELDER HEALTH (01) | |
536910001 | (05) | MD |
54839 | AMERIGROUP (01) | |
A745 | BLUE CROSS BLUE SHIELD (01) | |
E36828 | (02) | |
N0564 | HEALTHRIGHT (01) |