Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1676 | NC |
NPI | 1013060763 |
---|---|
Provider Name | Dr. Juli Anne Swaim |
First Address | Statesville, NC 28625-8277 |
Second Address | Statesville, NC 28625-8277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 28/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0915V | BLUE CROSS BLUE SHIELD (01) | |
25728 | PARTNERS (01) | |
410035871 | MEDICARE RR (01) | |
61378 | OPTUM/SPECTERA/UNITED HEALTHCARE (01) | NC |
890915V | (05) | NC |
NC1676 | EYEMED (01) | NC |
U70094 | (02) |