=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487878138
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELAIR WOMENS CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 520 UPPER CHESAPEAKE DR SUITE 403
-----------------------------------------------------
City | BEL AIR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21014-4339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-643-4600
-----------------------------------------------------
Fax | 443-643-4606
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 467
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21009-0467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-643-4600
-----------------------------------------------------
Fax | 443-643-4606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. JAMES R SWANBECK JR.
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 443-643-4600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | D44713
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------