MEDICARE: DR. ROBERT MUROL 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
1	208000000X	Pediatrics Physician	01019126A	IN

General Provider Information

NPI Number	:	1962486266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MUROL SWEENEY M.D.

Provider Business Mailing Address
First Line	:	328 N MICHIGAN ST
Second Line	:	STE. 200
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1244
Country	:	US
Telephone Number	:	574-647-1845
Fax Number	:	574-647-1825

Provider Business Practice Location Address
First Line	:	100 NAVARRE PL
Second Line	:	STE. 4440
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1156
Country	:	US
Telephone Number	:	574-647-4540
Fax Number	:

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/08/2007

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