MEDICARE: SHYAM SUNDAR SWAIN 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	208VP0014X	Interventional Pain Medicine Physician	ME0069790	FL

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	:	1851433379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYAM SUNDAR SWAIN MD

Provider Business Mailing Address
First Line	:	7105 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1048
Country	:	US
Telephone Number	:	352-596-1339
Fax Number	:	352-596-8772

Provider Business Practice Location Address
First Line	:	7105 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-1048
Country	:	US
Telephone Number	:	352-596-1339
Fax Number	:	352-596-8772

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	03/27/2018

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