Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT206660 | PA |
N | 208600000X | Surgeon | MT206660 | PA |
Y | 2086S0120X | Pediatric Surgery | 12229874-1205 | UT |
NPI | 1457765919 |
---|---|
Provider Name | Dr. Robert A. Swendiman |
First Address | Salt Lake City, UT 84113-1103 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2014 |
Last Update Date | 13/12/2021 |