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Individual

JOHN DAVID SWANSON IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
750 N SYRINGA ST STE 100, POST FALLS, ID 83854-5275
(208) 262-2600
(208) 262-2700
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-9075
ID
2083A0100X
Aerospace Medicine Physician
M-9075
ID
2083X0100X
Occupational Medicine Physician
M-9075
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255459558
ID
Enumeration date
03/26/2007
Last updated
08/22/2024
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