Healthcare Provider Details

I. General information

NPI: 1942629365
Provider Name (Legal Business Name): CORINNE MARIE SWEARINGEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 N 51ST ST # P309
MILWAUKEE WI
53210-1645
US

IV. Provider business mailing address

3070 N 51ST ST # P309
MILWAUKEE WI
53210-1645
US

V. Phone/Fax

Practice location:
  • Phone: 414-447-7330
  • Fax: 414-447-1070
Mailing address:
  • Phone: 144-477-3304
  • Fax: 414-447-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number64925-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: