Provider Demographics
NPI:1295757318
Name:SWISHER, JENETTE (MD)
Entity type:Individual
Prefix:
First Name:JENETTE
Middle Name:
Last Name:SWISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 TATE BLVD SE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4042
Mailing Address - Country:US
Mailing Address - Phone:828-345-0800
Mailing Address - Fax:828-345-0350
Practice Address - Street 1:915 TATE BLVD SE
Practice Address - Street 2:SUITE 170
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-345-0800
Practice Address - Fax:828-345-0350
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97001165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG66587Medicare UPIN
NC208348AMedicare ID - Type UnspecifiedMEDICARE NUMBER