Provider Demographics
NPI:1902011885
Name:HYDE, ROBERT NELSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NELSON
Last Name:HYDE
Suffix:III
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 1:12 ROOSEVELT DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2117
Mailing Address - Country:US
Mailing Address - Phone:203-736-6186
Mailing Address - Fax:
Practice Address - Street 1:111 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-2197
Practice Address - Country:US
Practice Address - Phone:203-736-9214
Practice Address - Fax:203-736-9172
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023888208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT07D0097603OtherCLIA