Individual
LYLE JAMES SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082
(651) 439-1234
(651) 430-8591
Mailing address
8170 33RD AVE, MS: 211110Q, BLOOMINGTON, MN 55425-4516
(651) 439-1234
(651) 430-8591
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
24407
MN
207RI0011X
Interventional Cardiology Physician
Primary
24407
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30744400
—
WI
05
—
562382100
—
MN
Enumeration date
12/08/2005
Last updated
03/07/2023
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