Provider Demographics
NPI:1093001208
Name:GOWANS, JOHN MATHEW (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MATHEW
Last Name:GOWANS
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 1:115 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-3869
Mailing Address - Country:US
Mailing Address - Phone:864-725-7272
Mailing Address - Fax:864-725-5799
Practice Address - Street 1:115 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-3869
Practice Address - Country:US
Practice Address - Phone:864-725-7272
Practice Address - Fax:864-725-5799
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38062208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation