Healthcare Provider Details

I. General information

NPI: 1093768913
Provider Name (Legal Business Name): DONNA C SWEETS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SAINT MARYS DR SUITE 309E
EVANSVILLE IN
47714-0511
US

IV. Provider business mailing address

PO BOX 359
EVANSVILLE IN
47703-0359
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-1850
  • Fax: 812-485-1855
Mailing address:
  • Phone: 812-485-1220
  • Fax: 812-485-8544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number02002168
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: