Individual
JANE VANCE GWINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
48 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 458-7431
(864) 458-7463
Mailing address
PO BOX 2145, SKYLAND, NC 28776-2145
(828) 575-2644
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
11118
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111186
—
SC
01
—
AA74976910
MEDICARE PTAN
SC
Enumeration date
11/04/2005
Last updated
11/16/2015
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