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NPI Code Detail

MEDICARE: BRYAN CHRISTOPHER SWANSON D.O.

MEDICARE:   BRYAN CHRISTOPHER SWANSON  D.O.
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
1207P00000XEmergency Medicine Physician02003447AIN

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 : 1255570263
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN CHRISTOPHER SWANSON D.O.
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line :
City : DYER
State : IN
Zip : 46311-0800
Country : US
Telephone Number : 219-864-2107
Fax Number : 219-864-2649
Provider Business Practice Location Address
First Line : 35491 EAGLE WAY
Second Line :
City : CHICAGO
State : IL
Zip : 60678-0001
Country : US
Telephone Number : 219-864-2107
Fax Number : 219-864-2649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2009
Last Update Date : 07/20/2011

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Directions to “ BRYAN CHRISTOPHER SWANSON D.O.” Practice Location

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