Provider Demographics
NPI:1952384943
Name:GUM, GREGORY KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:KEVIN
Last Name:GUM
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 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL135192085R0202X
LAMD.0167482085R0202X
TN551392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009910968Medicaid
AL113988Medicaid
AL83078Medicaid
AL9943108Medicaid
AL9952730Medicaid
AL141126Medicaid
AL146038Medicaid
AL157611Medicaid
AL219165Medicaid
AL227464Medicaid
AL247786Medicaid
AL51595666OtherBCBS
AL126892Medicaid
AL140938Medicaid
AL141127Medicaid
AL247870Medicaid
AL249249Medicaid
51100056OtherBCBS
AL51595664OtherBCBS
AL51595670OtherBCBS
AL247898Medicaid
AL248843Medicaid
AL51595671OtherBCBS
AL9933393Medicaid
AL9942877Medicaid
AL114423Medicaid
AL117342Medicaid
AL136040Medicaid
AL210884Medicaid
AL227160Medicaid
AL227176Medicaid
AL51595668OtherBCBS
AL9933899Medicaid
AL128402Medicaid
AL247632Medicaid
AL009942877Medicaid
AL140934Medicaid
AL149478Medicaid
AL236980Medicaid
AL51595667OtherBCBS