Individual
EDWIN RUSSELL SWANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4822 SIX FORKS RD, SUITE 104, RALEIGH, NC 27609-5269
(919) 782-4933
(919) 782-4934
Mailing address
4822 SIX FORKS RD, SUITE 104, RALEIGH, NC 27609-5269
(919) 782-4933
(919) 782-4934
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21724
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8981125
—
NC
Enumeration date
08/05/2006
Last updated
12/22/2010
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