Organization
SWAN DERMATOLOGY CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI SIEGERT SWAN MD (PRESIDENT)
(765) 446-0282
Entity
Organization
Contact information
Practice address
2020 UNION ST., SUITE 300, LAFAYETTE, IN 47904
(765) 446-0282
(765) 446-8299
Mailing address
2020 UNION ST., SUITE 300, LAFAYETTE, IN 47904
(765) 446-0282
(765) 446-8299
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01042461
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE9089
RR MEDICARE
IN
Enumeration date
07/07/2006
Last updated
05/16/2008
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