Individual
SHAWN T SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1419 W BELLA DR, MARION, IN 46953-5250
(765) 660-7580
(765) 664-0469
Mailing address
330 N WABASH, SUITE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01045148A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000762672
ANTHEM
IN
05
—
200100150A
—
IN
Enumeration date
05/23/2005
Last updated
10/19/2020
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