MEDICARE: ELIZABETH BANOWSKY SWAIN

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	235Z00000X	Speech-Language Pathologist	SLP005165	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1437286556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BANOWSKY SWAIN

Provider Business Mailing Address
First Line	:	2522 SPARROW CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2522 SPARROW CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5006
Country	:	US
Telephone Number	:	706-536-9731
Fax Number	:

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	09/01/2011

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