Provider Demographics
NPI:1336158401
Name:SWARTZ, ANDREW WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WAYNE
Last Name:SWARTZ
Suffix:
Gender:M
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:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:GIRDWOOD
Mailing Address - State:AK
Mailing Address - Zip Code:99587-0069
Mailing Address - Country:US
Mailing Address - Phone:907-783-0067
Mailing Address - Fax:
Practice Address - Street 1:5005 RASPBERRY RD
Practice Address - Street 2:176 MDG, KULIS ANGB
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-1982
Practice Address - Country:US
Practice Address - Phone:907-249-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKH55303Medicare UPIN