Basic Information
| Provider Information | |||||||||
| NPI: | 1508339250 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWARTZ | ||||||||
| FirstName: | SAMUEL | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9134 COATS RD | ||||||||
| Address2: | |||||||||
| City: | LINDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283569558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306052405 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1638 OWEN DR | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106154000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2019 | ||||||||
| LastUpdateDate: | 02/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 0010-08714 | NC | N | Allopathic & Osteopathic Physicians | Hospitalist | 363A00000X | 0010-08714 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 207R00000X | 0010-08714 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.