MEDICARE: DR. JENNIFER L. SWANSON 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	207P00000X	Emergency Medicine Physician	034174	NC

General Provider Information

NPI Number	:	1518018308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER L. SWANSON M.D.

Provider Business Mailing Address
First Line	:	4222 NEW LEAF LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-7918
Country	:	US
Telephone Number	:	919-941-1911
Fax Number	:	919-941-1901

Provider Business Practice Location Address
First Line	:	5400 S. MIAMI BLVD.
Second Line	:	SUITE 112
City	:	DURHAM
State	:	NC
Zip	:	27703-8465
Country	:	US
Telephone Number	:	919-941-1911
Fax Number	:	919-941-1901

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	01/19/2010

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