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Individual

BLYTHE W SWAIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
601 E SIX FORKS RD STE 102, RALEIGH, NC 27609-7742
(919) 228-2415
(919) 228-2416
Mailing address
601 E SIX FORKS RD STE 102, RALEIGH, NC 27609-7742
(919) 228-2415
(919) 228-2416

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00780
NC
363AM0700X
Medical Physician Assistant
0010-00780
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010-00780
NC MEDICAL BOARD LICENSE
NC
Enumeration date
01/22/2007
Last updated
12/15/2025
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