Individual
RANDY L SWACKHAMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 WAYNE MEMORIAL DR STE C, GOLDSBORO, NC 27534-1750
(919) 988-9674
(919) 988-9676
Mailing address
2400 WAYNE MEMORIAL DR STE C, GOLDSBORO, NC 27534-1750
(919) 988-9674
(919) 988-9676
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33315
NC
208D00000X
General Practice Physician
33315
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012769800001
—
PA
01
—
P01133879
RAILROAD MEDICARE PTAN
NC
Enumeration date
03/19/2007
Last updated
01/18/2017
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