Healthcare Provider Details

I. General information

NPI: 1972562031
Provider Name (Legal Business Name): KAREN MARIE SWANSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26711 WOODWARD AVE STE 103
HUNTINGTON WOODS MI
48070-1333
US

IV. Provider business mailing address

26711 WOODWARD AVE STE 103
HUNTINGTON WOODS MI
48070-1333
US

V. Phone/Fax

Practice location:
  • Phone: 248-543-6000
  • Fax: 248-543-3770
Mailing address:
  • Phone: 248-543-6000
  • Fax: 248-543-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberKS045311
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: