Provider Demographics
NPI:1558392878
Name:SWEARINGEN, CHAD L (PA-C)
Entity Type:Individual
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First Name:CHAD
Middle Name:L
Last Name:SWEARINGEN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4200 DAHLBERG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4840
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5600
Practice Address - Street 1:9630 GROVE CIR N
Practice Address - Street 2:SUITE 300
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-3464
Practice Address - Country:US
Practice Address - Phone:763-520-7870
Practice Address - Fax:763-520-7580
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-02-13
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Provider Licenses
StateLicense IDTaxonomies
MN9827363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN070948400Medicaid
MNP68909Medicare UPIN
MN970001804Medicare ID - Type Unspecified