Provider Demographics
NPI:1720274566
Name:FRANCIS W SWIERUPSKI DPM
Entity Type:Organization
Organization Name:FRANCIS W SWIERUPSKI DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SWIERUPSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-586-0540
Mailing Address - Street 1:500 BELMONT ST
Mailing Address - Street 2:#110
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4985
Mailing Address - Country:US
Mailing Address - Phone:508-586-0540
Mailing Address - Fax:508-588-0466
Practice Address - Street 1:500 BELMONT ST
Practice Address - Street 2:#110
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4985
Practice Address - Country:US
Practice Address - Phone:508-586-0540
Practice Address - Fax:508-588-0466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCIS W SWIERUPSKI DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-14
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPOD1761213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0361593Medicaid
MAY70817OtherBC/BS
MA0361593Medicaid
T19139Medicare UPIN