MEDICARE: TODD D GWIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	14232	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180018827	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1050550001	OTHER	DMERC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225030208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD D GWIN MD

Provider Business Mailing Address
First Line	:	1520 BOILING SPRINGS RD
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316
Country	:	US
Telephone Number	:	864-583-6381
Fax Number	:	864-583-5337

Provider Business Practice Location Address
First Line	:	1520 BOILING SPRINGS RD
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316
Country	:	US
Telephone Number	:	864-583-6381
Fax Number	:	864-583-5337

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/22/2023

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Directions to “ TODD D GWIN MD” Practice Location

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