Healthcare Provider Details

I. General information

NPI: 1174766034
Provider Name (Legal Business Name): RONALD SCOTT SWANGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 EUREKA AVE
RENO NV
89512-3425
US

IV. Provider business mailing address

16190 TANEA DR
RENO NV
89511-8180
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-5083
  • Fax:
Mailing address:
  • Phone: 775-737-4515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA120966
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA120966
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number251680
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number251680
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number14291
License Number StateNV
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number14291
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: