Provider Demographics
NPI:1326027954
Name:SWIGLO, BRIAN ALAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ALAN
Last Name:SWIGLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:651-241-5000
Mailing Address - Fax:612-262-4258
Practice Address - Street 1:255 SMITH AVE N
Practice Address - Street 2:SUITE 100 UNITED MEDICAL SPECIALTIES ST PAUL
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2572
Practice Address - Country:US
Practice Address - Phone:651-241-5000
Practice Address - Fax:651-241-7678
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45875207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN195172600Medicaid
MNP00246750Medicare ID - Type UnspecifiedRAILROAD
I28744Medicare UPIN
MN195172600Medicaid