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Organization

MICHAEL SHWAYDER MD A PROFESSIONAL CORPORATION

Active
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Organization

MICHAEL SHWAYDER MD A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL W T SHWAYDER M.D. (PRESIDENT)
(310) 301-0015
Entity
Organization

Contact information

Practice address
6801 PARK TERRACE DR, SUITE 530B, LOS ANGELES, CA 90045-1543
(310) 301-0015
(310) 301-4882
Mailing address
6801 PARK TERRACE DR, SUITE 530B, LOS ANGELES, CA 90045-1543
(310) 301-0015
(310) 301-4882

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
W14324
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W14324
GROUP MEDICARE NUMBER
CA
Enumeration date
10/30/2007
Last updated
03/30/2020
About Stedi
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