Provider Demographics
NPI:1720469539
Name:SWEIS, NADEEN Z (MD)
Entity Type:Individual
Prefix:
First Name:NADEEN
Middle Name:Z
Last Name:SWEIS
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 1:350 PELLER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4543
Mailing Address - Country:US
Mailing Address - Phone:262-249-0221
Mailing Address - Fax:262-249-0633
Practice Address - Street 1:350 PELLER RD
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4543
Practice Address - Country:US
Practice Address - Phone:262-249-0221
Practice Address - Fax:262-249-0633
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107823207Q00000X
WI70318-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1720469539OtherBCBSWI
WI1765OtherMERCYCARE INSURANCE
WIK400603142OtherWI MEDICARE
WI1720469539Medicaid