MEDICARE: DR. ANDREW WAYNE SWARTZ 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
1	207Q00000X	Family Medicine Physician	4521	AK

General Provider Information

NPI Number	:	1336158401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW WAYNE SWARTZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	GIRDWOOD
State	:	AK
Zip	:	99587-0069
Country	:	US
Telephone Number	:	907-783-0067
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 RASPBERRY RD
Second Line	:	176 MDG, KULIS ANGB
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-1982
Country	:	US
Telephone Number	:	907-249-1276
Fax Number	:

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

Provider Enumeration Date	:	08/06/2006
Last Update Date	:	07/08/2007

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