Provider Demographics
NPI:1073606950
Name:SWAJIAN, GEORGE RICHARD (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RICHARD
Last Name:SWAJIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 STUTZ DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6266
Mailing Address - Country:US
Mailing Address - Phone:505-298-7099
Mailing Address - Fax:
Practice Address - Street 1:1404 STUTZ DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-6266
Practice Address - Country:US
Practice Address - Phone:505-298-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA 802 NM 84207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery