Individual
DR. MALIA G SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2525 13TH ST, BOULDER, CO 80304-4104
(303) 650-4460
Mailing address
1735 S PUBLIC RD STE 203, LAFAYETTE, CO 80026-7093
(303) 665-3036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39381
AL
207Q00000X
Family Medicine Physician
Primary
DR0069167
CO
390200000X
Student in an Organized Health Care Education/Training Program
L.4744
AL
390200000X
Student in an Organized Health Care Education/Training Program
MD.39381
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029476
KAISER COMMERCIAL NUMBER
CO
05
—
9000208841
—
CO
Enumeration date
06/14/2018
Last updated
08/03/2023
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