MEDICARE: DR. GAVIN C HAREWOOD M.D.

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	207RG0100X	Gastroenterology Physician	41632	MN
2	207RG0100X	Gastroenterology Physician	ME163485	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255317285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAVIN C HAREWOOD M.D.

Provider Business Mailing Address
First Line	:	CLEVELAND CLINIC INDIAN RIVER HOSPITAL
Second Line	:	3450 11TH CT STE 206
City	:	VERO BEACH
State	:	FL
Zip	:	32960
Country	:	US
Telephone Number	:	772-299-3511
Fax Number	:

Provider Business Practice Location Address
First Line	:	CLEVELAND CLINIC INDIAN RIVER HOSPITAL
Second Line	:	3450 11TH CT STE 206
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5012
Country	:	US
Telephone Number	:	722-299-3511
Fax Number	:

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	08/15/2023

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