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General NPI Number Information
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NPI Number | 1417444340
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Entity Type | Individual
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Provider Name | JOHN MICHAEL CONNOR SWEETNAM MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 275 COLLIER RD NW STE 300
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City | ATLANTA
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State | GA
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Zip | 30309-1740
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Country | US
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Telephone | 404-350-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 169 ASHLEY AVE RM 202
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City | CHARLESTON
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State | SC
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Zip | 29425-8905
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Country | US
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Telephone | 843-792-2731
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL52809
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 99045
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License Number State | GA
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