Provider Demographics
NPI:1518039296
Name:GWINN, GEORGE F (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:GWINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34597 N 60TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-5240
Mailing Address - Country:US
Mailing Address - Phone:480-473-7800
Mailing Address - Fax:480-513-8704
Practice Address - Street 1:34597 N 60TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-5240
Practice Address - Country:US
Practice Address - Phone:480-473-7800
Practice Address - Fax:480-513-8704
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25811207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77928Medicare PIN
AZE59196Medicare UPIN