Provider Demographics
NPI:1952394520
Name:MCSWAIN, MARK W (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:W
Last Name:MCSWAIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:161 GENESEE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3451
Mailing Address - Country:US
Mailing Address - Phone:315-255-0947
Mailing Address - Fax:315-255-0942
Practice Address - Street 1:161 GENESEE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3451
Practice Address - Country:US
Practice Address - Phone:315-255-0947
Practice Address - Fax:315-255-0942
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2015-02-27
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Provider Licenses
StateLicense IDTaxonomies
NY201382207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02364565Medicaid
NY02364565Medicaid