Provider Demographics
NPI:1982771150
Name:SWISHER, KAREN L (DPM)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:SWISHER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LEIGH
Other - Last Name:SWISHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:4800 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4194
Mailing Address - Country:US
Mailing Address - Phone:248-593-5121
Mailing Address - Fax:248-593-6533
Practice Address - Street 1:4800 BEACH RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4194
Practice Address - Country:US
Practice Address - Phone:248-593-5121
Practice Address - Fax:248-593-6533
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001743213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION28090Medicare ID - Type Unspecified
U6555Medicare UPIN