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General NPI Number Information
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NPI Number | 1033382049
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Entity Type | Individual
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Provider Name | BRAD B SWELSTAD MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 13580 GROUPE DR STE 105
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4163
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Country | US
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Telephone | 703-680-1770
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Fax | 855-402-1839
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Provider Business Mailing Address
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Address Line | 9600 BLACKWELL RD STE 500
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City | ROCKVILLE
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State | MD
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Zip | 20850-3783
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD60680871
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 0101265847
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | D0066846
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | N0491
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | A116519
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License Number State | CA
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