Provider Demographics
NPI:1689624256
Name:SWOGER, WILLIAM VINCENT (DO,FCCP,DABSM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VINCENT
Last Name:SWOGER
Suffix:
Gender:M
Credentials:DO,FCCP,DABSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 UNION AVE
Mailing Address - Street 2:SUITE 187
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3004
Mailing Address - Country:US
Mailing Address - Phone:330-343-4411
Mailing Address - Fax:330-364-1114
Practice Address - Street 1:515 UNION AVE
Practice Address - Street 2:SUITE 187
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3004
Practice Address - Country:US
Practice Address - Phone:330-343-4411
Practice Address - Fax:330-364-1114
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.005823207R00000X, 207RC0200X
OH34005823207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2151371Medicaid
OHG01957Medicare UPIN
OH0818964Medicare ID - Type Unspecified