# BETHEL MEDICAL GROUP, P. C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942400049
- **Authorized official:** DR. DAVID SHAPIRO M. D. (VICE-PRESIDENT)
- **Authorized official phone:** (203) 744-1639

## Contact information

- **Practice address:** 155 GREENWOOD AVE, BETHEL, CT 06801-2527
- **Practice address phone:** (203) 744-1639
- **Practice address fax:** (203) 748-1202
- **Mailing address:** 155 GREENWOOD AVE, BETHEL, CT 06801-2527
- **Mailing address phone:** (203) 744-1639
- **Mailing address fax:** (203) 748-1202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 016412 | CT | Yes |

## Other

- **Enumeration date:** 07/18/2007
- **Last updated:** 07/18/2007