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General NPI Number Information
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NPI Number | 1740842632
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Entity Type | Individual
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Provider Name | PHILLIP SHWAE MD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 421 CHEW ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3406
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Country | US
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Telephone | 866-785-8537
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Fax |
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Provider Business Mailing Address
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Address Line | 421 CHEW ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3406
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Country | US
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Telephone | 866-785-8537
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA12351600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 10145515
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD480122
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License Number State | PA
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