Provider Demographics
NPI:1013918879
Name:SWETZ, MARK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:SWETZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3065 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1239
Mailing Address - Country:US
Mailing Address - Phone:716-674-1414
Mailing Address - Fax:716-674-1473
Practice Address - Street 1:3065 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1239
Practice Address - Country:US
Practice Address - Phone:716-674-1414
Practice Address - Fax:716-674-1473
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-05-19
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Provider Licenses
StateLicense IDTaxonomies
NY194104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00175635OtherRAILROAD MEDICARE
NY3787523OtherAETNA
NY00010176002OtherUNIVERA
NY608008800OtherWC U.S. DEPT. OF LABOR
NY5904267OtherGHI
NY352240675OtherUNITED HEALTHCARE
000523769002OtherBC BS OF WNY
0107477OtherIHA
NY194104-6OtherWORKERS COMP
0107477OtherIHA
NY352240675OtherUNITED HEALTHCARE