Provider Demographics
NPI:1265532121
Name:SWARTZWELDER, THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:SWARTZWELDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NASH MEDICAL ARTS MALL
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1417
Mailing Address - Country:US
Mailing Address - Phone:252-937-8141
Mailing Address - Fax:252-443-9574
Practice Address - Street 1:500 NASH MEDICAL ARTS MALL
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1417
Practice Address - Country:US
Practice Address - Phone:252-937-8141
Practice Address - Fax:252-443-9574
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200742084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901337Medicaid
NC201622BMedicare ID - Type UnspecifiedMEDICARE
NCC80792Medicare UPIN