Individual
THOMAS SWEENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001337
IN
207P00000X
Emergency Medicine Physician
5101021493
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181698
ANTHEM
IN
05
—
100333170A
—
IN
05
—
114340127
—
MI
01
—
930101009
RAIL ROAD MEDICARE
IN
Enumeration date
04/08/2006
Last updated
02/08/2018
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