Provider Demographics
NPI:1922193762
Name:SWINEFORD, DANIEL PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:SWINEFORD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WEST ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2200
Mailing Address - Country:US
Mailing Address - Phone:508-473-2273
Mailing Address - Fax:508-473-2275
Practice Address - Street 1:184 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038
Practice Address - Country:US
Practice Address - Phone:508-528-2525
Practice Address - Fax:508-520-8901
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004636L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110117719AMedicaid
PA048309TYZMedicare ID - Type Unspecified