Individual
MR. THOMAS M SWEDENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
562 1ST STREET, MANISTEE, MI 49660-1579
(231) 723-0114
Mailing address
562 1ST ST, MANISTEE, MI 49660-1579
(231) 723-0114
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704204485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704204485
STATE LICENSE NUMBER
MI
05
—
4929820
—
MI
Enumeration date
02/06/2007
Last updated
10/04/2010
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