Healthcare Provider Details

I. General information

NPI: 1427805167
Provider Name (Legal Business Name): FRANK RANDOLPH SWANN IV MS, MPH, CGC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 MOLECULAR DR STE 218
ROCKVILLE MD
20850-7542
US

IV. Provider business mailing address

10110 MOLECULAR DR STE 218
ROCKVILLE MD
20850-7542
US

V. Phone/Fax

Practice location:
  • Phone: 301-315-2227
  • Fax: 301-315-2169
Mailing address:
  • Phone: 301-315-2227
  • Fax: 301-315-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberG0000200
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: