Healthcare Provider Details
I. General information
NPI: 1306825286
Provider Name (Legal Business Name): DENISE MARY SWIDWA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1704 PITTSBURGH ST
CHESWICK PA
15024-1526
US
IV. Provider business mailing address
715 BLUE RIDGE RD
PITTSBURGH PA
15239-2802
US
V. Phone/Fax
- Phone: 724-274-4320
- Fax: 724-274-4332
- Phone: 724-274-4320
- Fax: 724-274-4332
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | MD021100E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: