MEDICARE: DR. EDWIN SWIATLO MD, PHD

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	207RI0200X	Infectious Disease Physician	15572	MS
2	207RI0200X	Infectious Disease Physician	334371	LA

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
3	RR440002696	OTHER	MS	RAILROAD

General Provider Information

NPI Number	:	1982630075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN SWIATLO MD, PHD

Provider Business Mailing Address
First Line	:	1631 ELYSIAN FIELDS AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117
Country	:	US
Telephone Number	:	504-821-2601
Fax Number	:	888-736-9806

Provider Business Practice Location Address
First Line	:	1631 ELYSIAN FIELDS AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117
Country	:	US
Telephone Number	:	504-821-2601
Fax Number	:	888-736-9806

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	03/14/2025

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