Individual
ELIZABETH A SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
49108
CO
207NP0225X
Pediatric Dermatology Physician
M15214
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305413000
—
MN
05
—
48703737
—
CO
01
—
P00405227
MEDICARE RAILROAD
MN
Enumeration date
02/10/2006
Last updated
06/04/2025
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