Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD60680871 | WA |
N | 207VE0102X | Reproductive Endocrinologist | 0101265847 | VA |
Y | 207VE0102X | Reproductive Endocrinologist | A116519 | CA |
N | 207VE0102X | Reproductive Endocrinologist | D0066846 | MD |
N | 207VE0102X | Reproductive Endocrinologist | N0491 | TX |
NPI | 1033382049 |
---|---|
Provider Name | Dr. Brad B Swelstad |
First Address | Rockville, MD 20850-3783 |
Second Address | Woodbridge, VA 22192-4163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2008 |
Last Update Date | 27/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018471300 | (05) | MD |