Healthcare Provider Details

I. General information

NPI: 1568845444
Provider Name (Legal Business Name): BRYAN H SWAIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 PLEASANT ST STE A300
WATERTOWN MA
02472-2463
US

IV. Provider business mailing address

330 MOUNT AUBURN ST PARSONS 2
CAMBRIDGE MA
02138-5597
US

V. Phone/Fax

Practice location:
  • Phone: 607-926-9000
  • Fax: 617-926-7053
Mailing address:
  • Phone: 607-926-9000
  • Fax: 617-926-7053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number277203
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: