Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC-002973-L | PA |
NPI | 1386752780 |
---|---|
Provider Name | Dr. Michael Steven Swank |
First Address | Dover, PA 17315-3507 |
Second Address | Dover, PA 17315-3507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2006 |
Last Update Date | 13/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034372 | BLUE SHIELD (01) | |
T27225 | (02) | PA |