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NPI Code Detail

MEDICARE: MRS. ANGELICA LYNN SWIERSZ M.D.

MEDICARE: MRS. ANGELICA LYNN SWIERSZ M.D.
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
1208000000XPediatrics PhysicianNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073586194
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELICA LYNN SWIERSZ M.D.
Provider Business Mailing Address
First Line : 1321 OBERLIN RD
Second Line : A
City : RALEIGH
State : NC
Zip : 27608-2052
Country : US
Telephone Number : 919-828-4747
Fax Number : 919-828-6765
Provider Business Practice Location Address
First Line : 1321 OBERLIN RD
Second Line : A
City : RALEIGH
State : NC
Zip : 27608-2052
Country : US
Telephone Number : 919-828-4747
Fax Number : 919-828-6765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 07/08/2007

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