Healthcare Provider Details

I. General information

NPI: 1407910730
Provider Name (Legal Business Name): EDWARD JOSEPH SWANTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 YORK RD STE 506
LUTHERVILLE MD
21093-6022
US

IV. Provider business mailing address

11627 FEDERAL ST
FULTON MD
20759-2664
US

V. Phone/Fax

Practice location:
  • Phone: 410-825-2281
  • Fax: 410-825-2280
Mailing address:
  • Phone: 410-507-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD31098
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberD0068625
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: