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General NPI Number Information
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NPI Number | 1215066634
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Entity Type | Organization
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Legal Business Name | JOHN M SWANGIM DPM
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 940 QUAIL RIDGE DR
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City | PORTER
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State | IN
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Zip | 46304-1047
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Country | US
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Telephone | 219-395-8752
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Fax |
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Provider Business Mailing Address
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Address Line | 940 QUAIL RIDGE DR
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City | PORTER
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State | IN
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Zip | 46304-1047
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Country | US
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Telephone | 219-395-8752
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. JOHN MICHAEL SWANGIM
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Credential | DPM
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Telephone | 219-395-8752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000859A
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License Number State | IN
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