Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 10263 | CT |
N | 204E00000X | Oral & Maxillofacial Surgeon | 048790 | CT |
Y | 208200000X | Surgeon | 048790 | CT |
Y | 208600000X | Surgeon | 048790 | CT |
N | 2086S0122X | Plastic and Reconstructive Surgery | 048790 | CT |
NPI | 1083687529 |
---|---|
Provider Name | Dr. Derek Matthew Steinbacher |
First Address | New Haven, CT 06520-8041 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 27/04/2021 |