Provider Demographics
NPI:1619989944
Name:SWANBECK, JAMES RAYMOND JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAYMOND
Last Name:SWANBECK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-0467
Mailing Address - Country:US
Mailing Address - Phone:443-643-4600
Mailing Address - Fax:443-643-4606
Practice Address - Street 1:510 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 518
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4328
Practice Address - Country:US
Practice Address - Phone:443-643-4530
Practice Address - Fax:443-643-4535
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD44713207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0888214Medicaid
MDC66704Medicare UPIN
MD493RMedicare ID - Type Unspecified