Provider Demographics
NPI:1073552774
Name:BELL, GREGORY D (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MERIDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3268
Mailing Address - Country:US
Mailing Address - Phone:860-276-5208
Mailing Address - Fax:860-276-5186
Practice Address - Street 1:81 MERIDEN AVE
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-3268
Practice Address - Country:US
Practice Address - Phone:860-276-5208
Practice Address - Fax:860-276-5186
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT36055207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG37939Medicare UPIN