Wilterdink, David Martin

Wilterdink, David Martin is an sole proprietor health care provider with primary practice located at 45 Green Hollow Rd , Danielson CT 06239-3509. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wilterdink, David Martin can be contacted via phone (860) 774-1255.

Contact Information

Primary practice address
45 Green Hollow Rd Danielson CT 06239-3509
Phone: (860) 774-1255
Fax: (860) 779-2059
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 023759 Connecticut
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 023759 Connecticut

Profile Details

NPI number 1538144548
LBN Legal business name Wilterdink, David Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2005
Last updated Apr 9th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538144548 NPPES
Connecticut MEDICAID 001237593

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