Individual
DR. CRAIG ROBERT SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
10174 OTTER DR, SOUTH LYON, MI 48178-8873
(248) 722-9598
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003253
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383655994
MEBS
MI
01
—
383655994
BCI ADMINISTRATORS
—
01
—
462242001
ADMINISTAR
—
01
—
C5003253
BCBS
—
Enumeration date
04/22/2006
Last updated
12/02/2024
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