Provider Demographics
NPI:1366488256
Name:GUTWEIN, DOROTHY (MD)
Entity Type:Individual
Prefix:MISS
First Name:DOROTHY
Middle Name:
Last Name:GUTWEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CORPORATE DR
Mailing Address - Street 2:SUITE #484
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6211
Mailing Address - Country:US
Mailing Address - Phone:203-944-9898
Mailing Address - Fax:203-944-9899
Practice Address - Street 1:4 CORPORATE DR
Practice Address - Street 2:SUITE #484
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6211
Practice Address - Country:US
Practice Address - Phone:203-944-9898
Practice Address - Fax:203-944-9899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026964207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD03001Medicare UPIN