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NPI Code Detail

MEDICARE: MR. ANDREW ALLAN GWALTNEY

MEDICARE:  MR. ANDREW ALLAN GWALTNEY
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1447849336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW ALLAN GWALTNEY
Provider Business Mailing Address
First Line : 2128 MOUNTAIN VIEW DR # 2128
Second Line :
City : VESTAVIA HILLS
State : AL
Zip : 35216-2024
Country : US
Telephone Number : 205-937-4285
Fax Number :
Provider Business Practice Location Address
First Line : 2128 MOUNTAIN VIEW DR # 2128
Second Line :
City : VESTAVIA HILLS
State : AL
Zip : 35216-2024
Country : US
Telephone Number : 205-937-4285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2021
Last Update Date : 01/14/2021

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Directions to “ MR. ANDREW ALLAN GWALTNEY ” Practice Location

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