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General NPI Number Information
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NPI Number | 1649671694
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Entity Type | Organization
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Legal Business Name | SAGINAW SWIFTCARE
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 1209 N SAGINAW BLVD SUITE F
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City | SAGINAW
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State | TX
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Zip | 76179-1169
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Country | US
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Telephone | 301-455-5945
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 N SAGINAW BLVD SUITE F
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City | SAGINAW
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State | TX
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Zip | 76179-1169
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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 | PHYSICIAN
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Name | DR. ADETUNJI ENITAN ADESANOYE
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Credential | MD
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Telephone | 301-455-5945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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