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NPI Code Detail

MEDICARE: DR. RAYMOND ELMER SWANSON MD

MEDICARE:  DR. RAYMOND ELMER SWANSON  MD
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
1291U00000XClinical Medical Laboratory010304708IN

General Provider Information

NPI Number : 1518209592
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND ELMER SWANSON MD
Provider Business Mailing Address
First Line : 207 ISLAND VIEW DR
Second Line :
City : GOSHEN
State : IN
Zip : 46526-5213
Country : US
Telephone Number : 574-533-0066
Fax Number :
Provider Business Practice Location Address
First Line : 207 ISLAND VIEW DR
Second Line :
City : GOSHEN
State : IN
Zip : 46526-5213
Country : US
Telephone Number : 574-533-0066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2013
Last Update Date : 03/18/2013

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Directions to “ DR. RAYMOND ELMER SWANSON MD” Practice Location

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