Provider Demographics
NPI:1386635837
Name:SWEARINGEN, BROOKE (MD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 331
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-3910
Practice Address - Fax:617-726-7546
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2012-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA56129207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3029361Medicaid
MA714052OtherTUFTS HEALTH PLAN
MAJ07004OtherBCBS MA
MA714052OtherTUFTS HEALTH PLAN
MAJ07004Medicare ID - Type Unspecified