MEDICARE: CARLOS MARIA SWANGER 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
1	207R00000X	Internal Medicine Physician	187595	NY

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

General Provider Information

NPI Number	:	1609819788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS MARIA SWANGER MD

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-368-3720
Fax Number	:	585-368-3723

Provider Business Practice Location Address
First Line	:	2400 S CLINTON AVE
Second Line	:	BUILDING H SUITE 110
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2668
Country	:	US
Telephone Number	:	585-271-3800
Fax Number	:	585-461-4426

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/05/2023

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