Provider Demographics
NPI:1790914547
Name:SWAMY, THEJAS N (MD)
Entity Type:Individual
Prefix:DR
First Name:THEJAS
Middle Name:N
Last Name:SWAMY
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 1:535 SAYBROOK RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4743
Mailing Address - Country:US
Mailing Address - Phone:860-344-8606
Mailing Address - Fax:860-344-8963
Practice Address - Street 1:535 SAYBROOK RD STE 5
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4743
Practice Address - Country:US
Practice Address - Phone:860-344-8606
Practice Address - Fax:860-344-8963
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051699207RN0300X, 207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5955504OtherCIGNA
CT2539259OtherCOVENTRY/FIRST HEALTH
CT929297OtherWELLCARE
CT5295851OtherAETNA
CTP4854527OtherUHC/OXFORD
CT1790914547Medicaid
CTP01262027OtherRAILROAD
CT051699OtherCONNECTICARE
CT929297OtherWELLCARE
CTFS3833628OtherDEA