Provider Demographics
NPI:1639565484
Name:SWAVELY, STEVEN C
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:SWAVELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 ST. PAUL PLACE
Mailing Address - Street 2:MERCY MEDICAL CENTER, BUNTING BUILDING, 7TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-332-9694
Mailing Address - Fax:
Practice Address - Street 1:345 ST. PAUL PLACE
Practice Address - Street 2:MERCY MEDICAL CENTER, BUNTING BUILDING, 7TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202
Practice Address - Country:US
Practice Address - Phone:410-332-9694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA858612084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program