Provider Demographics
NPI:1316009848
Name:SWANN, STEVEN WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALTER
Last Name:SWANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1660 GEORGES KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-7703
Mailing Address - Country:US
Mailing Address - Phone:703-602-8518
Mailing Address - Fax:703-602-7522
Practice Address - Street 1:1660 GEORGES KNOLL CT
Practice Address - Street 2:
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7703
Practice Address - Country:US
Practice Address - Phone:703-602-8518
Practice Address - Fax:703-602-7522
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD018093208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery