Individual
COLIN A BETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2130 MILLBURN AVENUE, SUITE C-1, MAPLEWOOD, NJ 07040
(888) 287-3652
(973) 549-6079
Mailing address
P.O. BOX 785361, PEDIATRIC SURGERY GROUP, PHILADELPHIA, PA 19178
(888) 282-3652
(973) 549-6079
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
25MA06559800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7346409
—
NJ
Enumeration date
07/11/2006
Last updated
12/21/2010
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