Individual
CARL W NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
033613
CT
207XP3100X
Pediatric Orthopaedic Surgery Physician
033613
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
33613
CT
Other
Enumeration date
06/28/2005
Last updated
11/19/2025
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