MEDICARE: MR. BRIAN MICHAEL M. SWANN P.A-C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	2308	FL

General Provider Information

NPI Number	:	1053386797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN MICHAEL M. SWANN P.A-C.

Provider Business Mailing Address
First Line	:	9912 LITTLE RD DEPT VETERANS
Second Line	:	PAS-PCC3
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3419
Country	:	US
Telephone Number	:	727-869-4100
Fax Number	:	727-869-4196

Provider Business Practice Location Address
First Line	:	9912 LITTLE RD
Second Line	:	VA-OPC-NPR / PCC3
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3419
Country	:	US
Telephone Number	:	727-869-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	07/24/2007

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