Individual
BRYAN K SWILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
673 MLK BLVD N, PONTIAC, MI 48342
(248) 338-2793
Mailing address
673 MLK BLVD N, PONTIAC, MI 48342
(248) 338-2793
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
BS010362
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001401
CAPE HEALTH PLAN
MI
01
—
0856308604
BCBS
MI
05
—
114402195
—
MI
01
—
132616
CARE CHOICES
MI
Enumeration date
08/01/2006
Last updated
11/15/2023
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