Provider Demographics
NPI:1275714008
Name:BECHER, ROBERT DAVID (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:BECHER
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CEDAR ST, SUITE 310
Mailing Address - Street 2:PO BOX 208062
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8062
Mailing Address - Country:US
Mailing Address - Phone:203-785-2572
Mailing Address - Fax:203-785-3950
Practice Address - Street 1:800 HOWARD AVENUE, 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-785-2572
Practice Address - Fax:203-785-3950
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135726208600000X
CT54313208600000X, 2086S0102X, 2086S0127X
PAMD4507782086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60171BMedicare UPIN