Gwyn, Michelle S
Gwyn, Michelle S is an individual health care provider with primary practice located at 1536 Eisenhower Pkwy , Macon GA 31206-3130. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Gwyn, Michelle S can be contacted via phone (478) 781-4333.Contact Information
Primary practice address
1536 Eisenhower Pkwy
Macon GA 31206-3130
Phone: (478) 781-4333
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN013195 | Georgia |
Profile Details
| NPI number | 1023083631 |
|---|---|
| LBN Legal business name | Gwyn, Michelle S |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 18th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023083631 | NPPES |
| Georgia | MEDICAID | 9180516 |
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