Provider Demographics
NPI:1184838799
Name:SWAYZE-QUINN, HANNAH (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SWAYZE-QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SWAYZE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATT: CVMC FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-225-1743
Mailing Address - Fax:802-225-1745
Practice Address - Street 1:130 FISHER RD
Practice Address - Street 2:HOSPITALIST PROGRAM
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-225-1743
Practice Address - Fax:802-225-1745
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0012714207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTP01338280OtherRAILROAD MEDICARE
VT1021914Medicaid
VT003423101Medicare PIN