Individual
DR. MIKELA JENNIFER SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13620 CRAYTON BLVD STE A, HAGERSTOWN, MD 21742-2335
(240) 313-3100
Mailing address
13620 CRAYTON BLVD STE A, HAGERSTOWN, MD 21742-2335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
055652
GA
207Q00000X
Family Medicine Physician
25772
WV
207Q00000X
Family Medicine Physician
Primary
D80691
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055652
STATE LICENSE #
GA
01
—
BS9070777
DEA
—
Enumeration date
07/24/2006
Last updated
12/11/2023
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