Provider Demographics
NPI:1568486702
Name:SWANSON, HARVEY CLARK (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:CLARK
Last Name:SWANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:66 CLAREMONT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3518
Mailing Address - Country:US
Mailing Address - Phone:406-751-5980
Mailing Address - Fax:406-751-5981
Practice Address - Street 1:66 CLAREMONT ST
Practice Address - Street 2:SUITE B
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3518
Practice Address - Country:US
Practice Address - Phone:406-751-5980
Practice Address - Fax:406-751-5981
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT4563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine