Provider Demographics
NPI:1396821880
Name:BELL, DWIGHT STEWART (MD)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:STEWART
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N SANTA ANITA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3113
Mailing Address - Country:US
Mailing Address - Phone:626-446-7792
Mailing Address - Fax:
Practice Address - Street 1:150 N SANTA ANITA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3113
Practice Address - Country:US
Practice Address - Phone:626-446-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG574952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF23142Medicare UPIN