Provider Demographics
NPI:1386621464
Name:SWALES, COLIN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:THOMAS
Last Name:SWALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:COLIN
Other - Middle Name:
Other - Last Name:SWALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2139 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2336
Mailing Address - Country:US
Mailing Address - Phone:860-257-4131
Mailing Address - Fax:860-257-4519
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-246-2571
Practice Address - Fax:860-246-3691
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048589207RG0100X, 207RT0003X, 207R00000X, 207RG0100X
MA222941207RT0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT003135317Medicaid
CT003135317Medicaid
MASWA39032Medicare ID - Type Unspecified