Provider Demographics
NPI:1497751127
Name:GEWIN, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:GEWIN
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 1:3140A CAHABA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5243
Mailing Address - Country:US
Mailing Address - Phone:205-967-9248
Mailing Address - Fax:205-967-7125
Practice Address - Street 1:3140A CAHABA HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-5243
Practice Address - Country:US
Practice Address - Phone:205-967-9248
Practice Address - Fax:205-967-7125
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10526207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC73377Medicare UPIN
AL80036Medicare ID - Type Unspecified