Individual
CHARLES M. SWANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1502 E BROADWAY, SUITE 210, COLUMBIA, MO 65201-8076
(573) 443-4591
(573) 874-1369
Mailing address
1502 E BROADWAY, SUITE 210, COLUMBIA, MO 65201-8076
(573) 443-4591
(573) 874-1369
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R2G66
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202739033
—
MO
Enumeration date
10/04/2005
Last updated
09/08/2011
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