Individual
JASON ALAN SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
(704) 334-7800
(704) 414-7512
Mailing address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
(704) 334-7800
(704) 414-7512
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2010-00755
NC
2085R0202X
Diagnostic Radiology Physician
34339
SC
2085R0204X
Vascular & Interventional Radiology Physician
2010-00755
NC
2085R0204X
Vascular & Interventional Radiology Physician
34339
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914759
—
NC
05
—
NC1128
—
SC
01
—
P00865060
RR MEDICARE
NC
Enumeration date
03/22/2007
Last updated
12/20/2017
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