Provider Demographics
NPI:1275646697
Name:SWAIN, RONALD II (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SWAIN
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 ORANGEBURG RD.
Mailing Address - Street 2:STE. C
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483
Mailing Address - Country:US
Mailing Address - Phone:843-900-7006
Mailing Address - Fax:843-771-3526
Practice Address - Street 1:949 ORANGEBURG RD.
Practice Address - Street 2:STE. C
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-900-7006
Practice Address - Fax:843-771-3526
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3611111N00000X
MI2301009115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11546418OtherCAQH