Provider Demographics
NPI:1215044045
Name:SWEDLUND, ROBERT DEAN (PA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DEAN
Last Name:SWEDLUND
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1410 FERN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-9376
Mailing Address - Country:US
Mailing Address - Phone:704-978-2250
Mailing Address - Fax:704-978-2258
Practice Address - Street 1:1410 FERN CREEK DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-9376
Practice Address - Country:US
Practice Address - Phone:704-978-2250
Practice Address - Fax:704-978-2258
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC101815363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101923Medicaid
NCP00122572OtherRAILROAD MEDICARE
NC8101923Medicaid
NC2751861FMedicare Oscar/Certification
NC2751861FMedicare Oscar/Certification