Provider Demographics
NPI:1386617983
Name:YEAGER, DAVID LEE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:YEAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-0591
Mailing Address - Country:US
Mailing Address - Phone:860-928-0815
Mailing Address - Fax:860-928-4514
Practice Address - Street 1:346 POMFRET ST
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1871
Practice Address - Country:US
Practice Address - Phone:860-928-0815
Practice Address - Fax:860-928-4514
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT016964207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT716455OtherTUFTS HEALTH PLAN
CT751969OtherCONNECTICARE
CT12009013OtherMULTIPLAN
CT4416694OtherAETNA
CTP369618OtherOXFORD HEALTH
CT010016964CT20OtherANTHEM BLUE CROSS
CT00116964800OtherBLUECARE FAMILY PLAN
CT051510OtherHEALTHNET
CT010016964CT20OtherANTHEM BLUE CROSS