Individual
GREGORY J SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 S MADISON ST, APPLETON, WI 54915-1846
(920) 730-4443
Mailing address
1501 S MADISON ST, APPLETON, WI 54915-1846
(920) 730-4443
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
44480
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34200600
—
WI
Enumeration date
09/07/2005
Last updated
06/17/2008
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