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NPI Code Detail

MEDICARE: DR. ADAM CHARLES SWANK M.D.

MEDICARE: DR. ADAM CHARLES SWANK 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
1207Q00000XFamily Medicine Physician46874MN

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 : 1205882594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM CHARLES SWANK M.D.
Provider Business Mailing Address
First Line : 4212 GRAND AVE
Second Line : ESSENTIA HEALTH WEST DULUTH CLINIC
City : DULUTH
State : MN
Zip : 55807-2737
Country : US
Telephone Number : 218-786-3500
Fax Number :
Provider Business Practice Location Address
First Line : 4212 GRAND AVE
Second Line : ESSENTIA HEALTH WEST DULUTH CLINIC
City : DULUTH
State : MN
Zip : 55807-2737
Country : US
Telephone Number : 218-786-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/11/2012

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Directions to “ DR. ADAM CHARLES SWANK M.D.” Practice Location

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