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1982658555

NPI Code Detail

MEDICARE: MARY E SWAIN MD

MEDICARE: MARY E 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	2085U0001X	Diagnostic Ultrasound Physician	ME55409	FL
2	2085R0202X	Diagnostic Radiology Physician	ME55409	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	10387	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982658555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY E SWAIN MD

Provider Business Mailing Address
First Line	:	PO BOX 1678
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32302-1678
Country	:	US
Telephone Number	:	850-878-4102
Fax Number	:	850-942-4155

Provider Business Practice Location Address
First Line	:	1600 PHILLIPS RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5304
Country	:	US
Telephone Number	:	850-878-4127
Fax Number	:	850-878-0337

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/06/2015

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Directions to “ MARY E SWAIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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