Provider Demographics
NPI:1043320187
Name:SWEARINGEN, JENNIFER ANN (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44000 W 12 MILE RD
Mailing Address - Street 2:STE 103
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2646
Mailing Address - Country:US
Mailing Address - Phone:248-946-4787
Mailing Address - Fax:248-308-2450
Practice Address - Street 1:44000 W 12 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2646
Practice Address - Country:US
Practice Address - Phone:248-946-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315039089207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology