Individual
MR. EDMUND A P WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 WHITEHALL AVE, RT 27, MYSTIC, CT 06355
(860) 572-8282
(860) 572-7445
Mailing address
56 WHITEHALL AVE, RT 27, MYSTIC, CT 06355
(860) 572-8282
(860) 572-7445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
015603
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010015603CT02
CTBC
CT
01
—
119004722
RI MC NUMBER
—
01
—
47229
RIBC
RI
Enumeration date
07/14/2006
Last updated
04/30/2015
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