Provider Demographics
NPI:1427035757
Name:SWAYNGIM, DOWZELL MEDFORD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DOWZELL
Middle Name:MEDFORD
Last Name:SWAYNGIM
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:703 TYLER ST
Mailing Address - Street 2:STE 351
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3391
Mailing Address - Country:US
Mailing Address - Phone:419-621-7620
Mailing Address - Fax:419-621-7623
Practice Address - Street 1:703 TYLER ST
Practice Address - Street 2:SUITE 251
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3367
Practice Address - Country:US
Practice Address - Phone:419-625-0599
Practice Address - Fax:419-625-3704
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2020-01-29
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Provider Licenses
StateLicense IDTaxonomies
OH0414262086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3700343OtherUNITED HEALTHCARE
OH0349840Medicaid
OH341328997011OtherMEDICAL MUTUAL OF OHIO
OH3700343OtherUNITED HEALTHCARE
OH341328997011OtherMEDICAL MUTUAL OF OHIO