# DANBURY MIDWIFERY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CCWC Professional Practice Group LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740639913
- **Authorized official:** DR. KENNETH PAUL BLAU MD (MANAGING PARTNER)
- **Authorized official phone:** (203) 748-6000

## Contact information

- **Practice address:** 94 LOCUST AVE, DANBURY, CT 06810-6032
- **Practice address phone:** (203) 748-6000
- **Practice address fax:** (203) 748-6771
- **Mailing address:** 94 LOCUST AVE, DANBURY, CT 06810-6032
- **Mailing address phone:** (203) 748-6000
- **Mailing address fax:** (203) 748-6771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 030587 | CT | Yes |

## Other

- **Enumeration date:** 06/08/2016
- **Last updated:** 12/05/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00130587100 | — | CT |