Healthcare Provider Details

I. General information

NPI: 1235169863
Provider Name (Legal Business Name): STUART C. BELKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MONROE TPKE
MONROE CT
06468-2276
US

IV. Provider business mailing address

2800 MAIN ST ST. VINCENTS MULTISPECIALTY GROUP
BRIDGEPORT CT
06606-4201
US

V. Phone/Fax

Practice location:
  • Phone: 203-696-3564
  • Fax: 203-268-8301
Mailing address:
  • Phone: 203-576-6133
  • Fax: 203-581-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number022644
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number22644
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number22644
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: