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General NPI Number Information
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NPI Number | 1124078977
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Entity Type | Individual
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Provider Name | KIRK PAUL SWABASH D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 5739 HIGHWAY M-68
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City | INDIAN RIVER
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State | MI
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Zip | 49749-9998
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Country | US
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Telephone | 608-821-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 WEISS ST
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City | SAGINAW
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State | MI
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Zip | 48602-5251
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Country | US
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Telephone | 989-497-2500
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101008685
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License Number State | MI
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