Provider Demographics
NPI:1104890508
Name:SWARTZ, CAROL TUSANG (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:TUSANG
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 COUNTY RD STE H
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4465
Mailing Address - Country:US
Mailing Address - Phone:775-782-3933
Mailing Address - Fax:775-782-1127
Practice Address - Street 1:1701 COUNTY RD STE H
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4465
Practice Address - Country:US
Practice Address - Phone:775-782-3933
Practice Address - Fax:775-782-1127
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10322208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506303Medicaid
NV100508874Medicaid