Provider Demographics
NPI:1669698544
Name:SWAIN, ANSHUMAN (MD)
Entity type:Individual
Prefix:
First Name:ANSHUMAN
Middle Name:
Last Name:SWAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:
Other - Last Name:SWAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2200 N LIMESTONE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2692
Mailing Address - Country:US
Mailing Address - Phone:937-717-0954
Mailing Address - Fax:937-521-3467
Practice Address - Street 1:2200 N LIMESTONE ST STE 102
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2692
Practice Address - Country:US
Practice Address - Phone:937-717-0954
Practice Address - Fax:937-521-3467
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.009032207L00000X
OH35.093405207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2955002Medicaid
OH4266931Medicare PIN