Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO2820 | FL |
NPI | 1538122114 |
---|---|
Provider Name | Dr. Christopher James Swartz |
First Address | Miami Shores, FL 33138-2145 |
Second Address | Miami, FL 33137-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65708 | BLUE CROSS BLUE SHIELD ID (01) | FL |
U79411 | (02) | FL |