MEDICARE: DR. ERIC MERRILL SWETERLITSCH 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	207RC0000X	Cardiovascular Disease Physician	ES067377	MI

General Provider Information

NPI Number	:	1962426213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC MERRILL SWETERLITSCH MD

Provider Business Mailing Address
First Line	:	200 S WENONA ST STE G94
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-8833
Country	:	US
Telephone Number	:	989-893-3392
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S WENONA ST STE G94
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-8833
Country	:	US
Telephone Number	:	989-893-3392
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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