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NPI Code Detail

MEDICARE: CHARLENE J SWEENEY M.D.

MEDICARE:   CHARLENE J SWEENEY  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
12084N0400XNeurology Physician4301081266MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MI43081266OTHERMIBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700866415
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE J SWEENEY M.D.
Provider Business Mailing Address
First Line : 1140 N STATE ST
Second Line :
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-643-0466
Fax Number :
Provider Business Practice Location Address
First Line : 1140 N STATE ST
Second Line :
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-643-0466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 02/10/2016

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Directions to “ CHARLENE J SWEENEY M.D.” Practice Location

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