Provider Demographics
NPI:1760659882
Name:AWSARE, SWATI (MD)
Entity Type:Individual
Prefix:DR
First Name:SWATI
Middle Name:
Last Name:AWSARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W.39TH AVE
Mailing Address - Street 2:SAN MATEO MEDICAL CENTER DEPT.OF MEDICINE
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4364
Mailing Address - Country:US
Mailing Address - Phone:650-573-2191
Mailing Address - Fax:650-573-2884
Practice Address - Street 1:222 W 39TH AVE
Practice Address - Street 2:SAN MATEO MEDICAL CENTER DEPT OF MEDICINE
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4364
Practice Address - Country:US
Practice Address - Phone:650-536-2191
Practice Address - Fax:650-573-2884
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG72041Medicare UPIN