Healthcare Provider Details

I. General information

NPI: 1063049658
Provider Name (Legal Business Name): ANAND R SWAMY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 N MAIN ST
FOUNTAIN INN SC
29644-1320
US

IV. Provider business mailing address

910 N MAIN ST
FOUNTAIN INN SC
29644-1320
US

V. Phone/Fax

Practice location:
  • Phone: 864-967-4982
  • Fax: 888-372-4903
Mailing address:
  • Phone: 864-967-4982
  • Fax: 888-372-4903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number83266
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: