Provider Demographics
NPI:1972229904
Name:SWIFT, DAWNISHA
Entity Type:Individual
Prefix:
First Name:DAWNISHA
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 VAN AKEN BLVD APT 210
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2270
Mailing Address - Country:US
Mailing Address - Phone:216-394-4322
Mailing Address - Fax:
Practice Address - Street 1:2830 VAN AKEN BLVD APT 210
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2270
Practice Address - Country:US
Practice Address - Phone:216-394-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTP262911171W00000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriver
No171W00000XOther Service ProvidersContractorGroup - Single Specialty