Provider Demographics
NPI:1861507790
Name:ALAN I GURWOOD
Entity type:Organization
Organization Name:ALAN I GURWOOD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:GURWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-451-2900
Mailing Address - Street 1:10 MAGNOLIA AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1760
Mailing Address - Country:US
Mailing Address - Phone:856-451-2900
Mailing Address - Fax:856-451-2866
Practice Address - Street 1:10 MAGNOLIA AVE
Practice Address - Street 2:SUITE H
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1760
Practice Address - Country:US
Practice Address - Phone:856-451-2900
Practice Address - Fax:856-451-2866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MD00102600213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ451177OtherAETNA/CAPITATED
NJ8660409Medicaid
NJCBS005OtherOXFORD
NJF0198-4OtherHEALTHNET
NJ1149549OtherHORIZON NJ HEALTH
NJ441480548OtherPAL GBA RAILROAD MEDICARE
NJ813564OtherAMERIHEALTH ADMINISTRATOR
NJ0667220001OtherNHIC
NJ4476083OtherAETNA/NON CAPITATED
NJ0862249000OtherAMERIHEALTH
NJ441480548OtherPAL GBA RAILROAD MEDICARE
NJCBS005OtherOXFORD
NJF0198-4OtherHEALTHNET
NJ813564Medicare ID - Type Unspecified
NJ8660409Medicaid