John Wade Candler, RRA
Individual provider Active NPI Radiology Practitioner Assistant · East Haddam, CT
NPI 1861969685 · NPPES record last updated Oct 30, 2018
Key facts
- NPI
- 1861969685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiology Practitioner Assistant 243U00000X
- License
- 294258
- Practice address
- 64 Wickham Rd
East Haddam, CT 06423-1203 - Phone
- (860) 917-5863
- NPI assigned
- Oct 30, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Practitioner Assistant | 243U00000X | 294258 | Yes |
Addresses
Primary practice location
64 Wickham Rd
East Haddam, CT 06423-1203
Mailing address
64 Wickham Rd
East Haddam, CT 06423-1203
Phone (860) 917-5863
Other providers in East Haddam, CT
- Joshua David Acocella-Stollerman
- Black Locust Psychology PC
- Chelsea Bristol
- Wayne F Dailey
- East Haddam Ambulance Assoc Inc
- Sherrie Gaudet
- Amy Gionta
- Brett Ashley Helmer
All providers in East Haddam, CT · Radiology Practitioner Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.