Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 5315039089 | MI |
NPI | 1043320187 |
---|---|
Provider Name | Jennifer Ann Swearingen |
First Address | Novi, MI 48377-2646 |
Second Address | Novi, MI 48377-2646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 14/06/2021 |