Organization
JOHN M SWANGIM DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M SWANGIM DPM (PRESIDENT)
(219) 324-8860
Entity
Organization
Contact information
Practice address
1300 STATE ST, SUITE 1E, LA PORTE, IN 46350-3185
(219) 324-8860
(219) 324-5671
Mailing address
1300 STATE ST, SUITE 1E, LA PORTE, IN 46350-3185
(219) 324-8860
(219) 324-5671
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000859A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184672727
GROUP MEMBER NPI
IN
05
—
200178550
—
IN
01
—
200992220A
GROUP/ORGANIZATION MEDICAID
IN
01
—
M100019840
MEDICARE GROUP/ORGANIZATION PTAN
IN
01
—
M400019841
MEDICARE GROUP MEMBER PTAN
IN
Enumeration date
06/04/2010
Last updated
05/11/2011
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