Provider Demographics
NPI:1558362178
Name:SWAIN, FREDERICK HENRY (DPM)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:HENRY
Last Name:SWAIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2101
Mailing Address - Country:US
Mailing Address - Phone:401-232-9077
Mailing Address - Fax:401-232-9077
Practice Address - Street 1:3 LAUREL CT
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2101
Practice Address - Country:US
Practice Address - Phone:401-232-9077
Practice Address - Fax:401-232-9077
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI 00172213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9007619Medicaid
RIBS5636444OtherDEA NARCOTICS
RI9007619Medicaid