Provider Demographics
NPI:1518975697
Name:GURWOOD, ALAN I (DPM)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:I
Last Name:GURWOOD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAGNOLIA AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1760
Mailing Address - Country:US
Mailing Address - Phone:856-451-2900
Mailing Address - Fax:856-451-2866
Practice Address - Street 1:10 MAGNOLIA AVE
Practice Address - Street 2:SUITE H
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1760
Practice Address - Country:US
Practice Address - Phone:856-451-2900
Practice Address - Fax:856-451-2866
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00102600213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4103772OtherAETNA/ NON CAPITATED
NJ0073986000OtherAMERIHEALTH
NJ3415406Medicaid
NJ813564OtherAMERIHEALTH ADMINISTRATOR
NJCBS005OtherOXFORD
NJ1149551OtherHORIZON NJ HEALTH
NJ634044OtherCIGNA
NJF0198-4OtherHEALTHNET
NJ000751837003OtherUNITED HEALTHCARE
NJ0667220001OtherNHIC
NJ38158OtherAETNA/ CAPITATED
NJ813564OtherAMERIHEALTH ADMINISTRATOR
NJ0667220001OtherNHIC
NJ1149551OtherHORIZON NJ HEALTH