Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 44223 | KY |
N | 208200000X | Surgeon | 44223 | KY |
N | 208600000X | Surgeon | 44223 | KY |
N | 2086S0105X | Surgery of the Hand | 44223 | KY |
Y | 2086S0129X | Vascular Surgeon | 70022 | CT |
NPI | 1306094776 |
---|---|
Provider Name | Bruce John Swearingen JR. |
First Address | Shelton, CT 06484-6228 |
Second Address | Stratford, CT 06614-1597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 10/01/2022 |