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General NPI Number Information
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NPI Number | 1932428885
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Entity Type | Individual
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Provider Name | PAUL VANSWEDEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 11635 NORTHPARK DR STE 250
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City | WAKE FOREST
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State | NC
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Zip | 27587-6298
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Country | US
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Telephone | 919-825-4637
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Fax | 919-562-0444
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Provider Business Mailing Address
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Address Line | 11635 NORTHPARK DR STE 250
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City | WAKE FOREST
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State | NC
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Zip | 27587-6298
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Country | US
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Telephone | 919-825-4637
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Fax | 919-562-0444
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2014-00622
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License Number State | NC
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