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General NPI Number Information
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NPI Number | 1679219117
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Entity Type | Individual
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Provider Name | PETER NORDSTROM SWAIN DO
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Gender | Male
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 155 WELLNESS WAY
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6797
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Country | US
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Telephone | 814-278-4818
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Fax | 814-234-6150
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Provider Business Mailing Address
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Address Line | 155 WELLNESS WAY
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6797
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Country | US
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Telephone | 814-231-7000
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Fax | 814-231-7098
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT021500
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS023158
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License Number State | PA
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