Provider Demographics
NPI:1942275490
Name:SWORDS, MICHAEL P (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:SWORDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2815 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3495
Mailing Address - Country:US
Mailing Address - Phone:517-267-0200
Mailing Address - Fax:517-267-1877
Practice Address - Street 1:2815 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3495
Practice Address - Country:US
Practice Address - Phone:517-267-0200
Practice Address - Fax:517-267-1877
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013922207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20000000086OtherPHYSICIANS HEALTH PLAN
MI200C313650OtherBLUECARE NETWORK
MI4838609Medicaid
MI300040412OtherTRICARE
MI1017938OtherMCLAREN HEALTH ADVANTAGE
MI200C313650OtherBCBS MI
MI20000000086OtherPHYSICIANS HEALTH PLAN
MI200C313650OtherBCBS MI
MI200C313650OtherBLUECARE NETWORK