Provider Demographics
NPI:1306045257
Name:SWENDER, DAVID ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:SWENDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:203 WINSTON DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-8526
Mailing Address - Country:US
Mailing Address - Phone:269-789-4380
Mailing Address - Fax:269-789-4381
Practice Address - Street 1:203 WINSTON DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-8526
Practice Address - Country:US
Practice Address - Phone:269-789-4380
Practice Address - Fax:269-789-4381
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019660207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0A37669Medicare PIN