Individual
MARY E SWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 PHILLIPS RD, TALLAHASSEE, FL 32308-5304
(850) 878-4127
(850) 878-0337
Mailing address
PO BOX 1678, TALLAHASSEE, FL 32302-1678
(850) 878-4102
(850) 942-4155
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME55409
FL
2085U0001X
Diagnostic Ultrasound Physician
ME55409
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000437346A
—
GA
05
—
000437346C
—
GA
05
—
000437346D
—
GA
05
—
063194900
—
FL
01
—
10387
BCBS
FL
Enumeration date
05/19/2006
Last updated
07/06/2015
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