Provider Demographics
NPI:1518030709
Name:DAVID R SWARNER MD PA
Entity Type:Organization
Organization Name:DAVID R SWARNER MD PA
Other - Org Name:DAVID R SWARNER MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:SWARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-975-7555
Mailing Address - Street 1:103 MOCKERNUT LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-9762
Mailing Address - Country:US
Mailing Address - Phone:252-975-7555
Mailing Address - Fax:252-975-1612
Practice Address - Street 1:103 MOCKERNUT LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-9762
Practice Address - Country:US
Practice Address - Phone:252-975-7555
Practice Address - Fax:252-975-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8981137Medicaid
NC2317810Medicare ID - Type Unspecified
NC8981137Medicaid