Provider Demographics
NPI:1972057826
Name:SWAFFORD, MEGHAN (PA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:SCHRADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 VAN AALST BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905
Mailing Address - Country:US
Mailing Address - Phone:757-406-0018
Mailing Address - Fax:
Practice Address - Street 1:6600 VAN AALST BOULEVARD
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:757-406-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant