MEDICARE: DR. TOD SWEENEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39385	CO
2	207QS0010X	Sports Medicine (Family Medicine) Physician	39385	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003813999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOD SWEENEY M.D.

Provider Business Mailing Address
First Line	:	6390 GARDENIA ST
Second Line	:	SUITE 140
City	:	ARVADA
State	:	CO
Zip	:	80004-3535
Country	:	US
Telephone Number	:	720-898-1110
Fax Number	:	720-898-1113

Provider Business Practice Location Address
First Line	:	6390 GARDENIA ST
Second Line	:	SUITE 140
City	:	ARVADA
State	:	CO
Zip	:	80004-3535
Country	:	US
Telephone Number	:	720-898-1110
Fax Number	:	720-898-1113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/25/2012

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