Provider Demographics
NPI:1598026684
Name:SWEARINGEN, RYAN M (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W 84TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6248
Mailing Address - Country:US
Mailing Address - Phone:219-736-1255
Mailing Address - Fax:219-738-1276
Practice Address - Street 1:400 W 84TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6248
Practice Address - Country:US
Practice Address - Phone:219-736-1255
Practice Address - Fax:219-738-1276
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100580390200000X
IN01078165A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program