Provider Demographics
NPI:1447849336
Name:GWALTNEY, ANDREW ALLAN
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ALLAN
Last Name:GWALTNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 MOUNTAIN VIEW DR # 2128
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2024
Mailing Address - Country:US
Mailing Address - Phone:205-937-4285
Mailing Address - Fax:
Practice Address - Street 1:2128 MOUNTAIN VIEW DR # 2128
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2024
Practice Address - Country:US
Practice Address - Phone:205-937-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program