Provider Demographics
NPI:1891711305
Name:SWENOR, MARGARET ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:SWENOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:M.
Other - Middle Name:ELIZABETH
Other - Last Name:SWENOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1961 S TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0246
Mailing Address - Country:US
Mailing Address - Phone:248-319-6210
Mailing Address - Fax:
Practice Address - Street 1:1961 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0246
Practice Address - Country:US
Practice Address - Phone:248-319-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0852410274OtherINDIVIDUAL BLUE CROSS
MI080A610030OtherGROUP BLUE CROSS
MI4742473Medicaid
MI4742473Medicaid
MI080A610030OtherGROUP BLUE CROSS