Organization
BETHEL MEDICAL GROUP PC
Active
Other names
Bethel Medical Group PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS R GROGAN M.D. (CEO)
(508) 588-1200
Entity
Organization
Contact information
Practice address
111 TORREY ST, BROCKTON, MA 02301-4800
(508) 588-1200
(508) 941-0497
Mailing address
PO BOX 848889, BOSTON, MA 02284-8889
(508) 588-1200
(508) 941-0497
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9780629
—
MA
Enumeration date
05/14/2007
Last updated
04/04/2016
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