Provider Demographics
NPI:1609902774
Name:GEWANTER, ALAN B (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:GEWANTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4354
Mailing Address - Country:US
Mailing Address - Phone:215-348-3681
Mailing Address - Fax:
Practice Address - Street 1:106 E STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4354
Practice Address - Country:US
Practice Address - Phone:215-348-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002198L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20224Medicare ID - Type Unspecified