MEDICARE: ROBERT B GWINN DO

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	207Q00000X	Family Medicine Physician	34003118	OH

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	:	1831194158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT B GWINN DO

Provider Business Mailing Address
First Line	:	223 BRENAIRD ST
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-9023
Country	:	US
Telephone Number	:	740-622-0332
Fax Number	:	740-622-0335

Provider Business Practice Location Address
First Line	:	440 BROWNS LN
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-2044
Country	:	US
Telephone Number	:	740-622-0332
Fax Number	:	740-622-0335

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/11/2013

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