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General NPI Number Information
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NPI Number | 1801846415
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Entity Type | Individual
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Provider Name | STEPHEN S SWENSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 713 ANDERSON AVE
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City | ST CLOUD
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State | MN
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Zip | 56303
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Country | US
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Telephone | 320-229-3761
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Fax | 320-229-3763
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Provider Business Mailing Address
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Address Line | 1406 6TH AVE N
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City | ST CLOUD
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State | MN
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Zip | 56303
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Country | US
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Telephone | 320-251-2700
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Fax | 320-656-7026
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 26476
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License Number State | MN
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