Provider Demographics
NPI:1154525244
Name:ELDER, ROBERT W JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:ELDER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:YALE UNIVERSITY, PEDIATRIC CARDIOLOGY, PO BOX 208064
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:YALE UNIVERSITY, PEDIATRIC CARDIOLOGY
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-785-2022
Practice Address - Fax:203-737-2786
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT186318207R00000X, 208000000X
CT520902080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics