Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME85725 | FL |
N | 208600000X | Surgeon | ME85725 | FL |
Y | 2086S0102X | Surgical Critical Care | ME85725 | FL |
NPI | 1033184270 |
---|---|
Provider Name | Dr. Andrew James Kerwin |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32209-6511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 03/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G75796 | (02) | FL |