Individual
THEODORE SWANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
386 COLLEGE AVE, CLEMSON, SC 29631-1475
(864) 654-2067
(864) 654-3261
Mailing address
386 COLLEGE AVE, CLEMSON, SC 29631-1432
(864) 654-2067
(864) 654-3261
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23395
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233955
—
SC
01
—
P00362791
RR MEDICARE
SC
Enumeration date
05/30/2006
Last updated
04/27/2010
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