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General NPI Number Information
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NPI Number | 1396943114
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Entity Type | Individual
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Provider Name | MICHAEL CAMERON SWEENEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 775 POLE LINE RD W STE 301
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City | TWIN FALLS
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State | ID
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Zip | 83301-5823
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Country | US
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Telephone | 208-814-8700
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Fax | 208-933-4914
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Provider Business Mailing Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6110
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35.125529
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 5571656
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 233665
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License Number State | ME
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