Provider Demographics
NPI:1891882478
Name:BROTHERS, DAVID M (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:BROTHERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W RIVER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461
Mailing Address - Country:US
Mailing Address - Phone:203-878-0666
Mailing Address - Fax:203-878-9938
Practice Address - Street 1:255 W RIVER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461
Practice Address - Country:US
Practice Address - Phone:203-878-0666
Practice Address - Fax:203-878-9938
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT015509207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000457OtherHN
427095OtherAETNA
NHS219OtherOXFORD
010015509CT01OtherBC BS
015509OtherCT CARE
015509OtherUHC
NHS219OtherOXFORD