Provider Demographics
NPI:1881738813
Name:SWANN, SANDRA L (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:SWANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1396 PICCARD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4302
Mailing Address - Country:US
Mailing Address - Phone:301-548-5869
Mailing Address - Fax:301-548-5882
Practice Address - Street 1:1396 PICCARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4302
Practice Address - Country:US
Practice Address - Phone:301-548-5869
Practice Address - Fax:301-548-5882
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0067634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine