Provider Demographics
NPI:1710141411
Name:MICHAEL MCSWEEN M D L L C
Entity Type:Organization
Organization Name:MICHAEL MCSWEEN M D L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCSWEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-341-1603
Mailing Address - Street 1:4700 WICHERS DR
Mailing Address - Street 2:STE 202
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-341-2014
Mailing Address - Fax:
Practice Address - Street 1:4700 WICHERS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-341-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty