Healthcare Provider Details
I. General information
NPI: 1972521151
Provider Name (Legal Business Name): JAMES M. SHWAYDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 03/02/2024
Certification Date: 03/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 SW ARCHER RD
GAINESVILLE FL
32610-9507
US
IV. Provider business mailing address
13413 ORINO ST
VENICE FL
34293-2743
US
V. Phone/Fax
- Phone: 352-273-7942
- Fax:
- Phone: 720-490-6940
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 22230 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 134448 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: