Provider Demographics
NPI:1295457778
Name:SWAD, WILLIAM BASIL (PA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BASIL
Last Name:SWAD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 PARK MEADOWS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5528
Mailing Address - Country:US
Mailing Address - Phone:720-640-7983
Mailing Address - Fax:
Practice Address - Street 1:10450 PARK MEADOWS DR STE 202
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5528
Practice Address - Country:US
Practice Address - Phone:720-640-7983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007544363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant