Individual
DR. JOHN SHANNON SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, YAW 6 RADIOLOGICAL ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-7717
(617) 726-5282
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-7633
(617) 726-5282
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
219268
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3149161
—
MA
01
—
468534
TUFTS HEALTH PLAN
MA
01
—
J26681
BCBS MA
MA
Enumeration date
11/18/2005
Last updated
08/10/2012
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