Provider Demographics
NPI:1386752780
Name:SWANK, MICHAEL STEVEN (MICHAEL SWANK, DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:SWANK
Suffix:
Gender:M
Credentials:MICHAEL SWANK, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4091 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-3507
Mailing Address - Country:US
Mailing Address - Phone:717-292-9500
Mailing Address - Fax:717-292-5946
Practice Address - Street 1:4091 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-3507
Practice Address - Country:US
Practice Address - Phone:717-292-9500
Practice Address - Fax:717-292-5946
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002973-L111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
034372OtherBLUE SHIELD
034372OtherBLUE SHIELD
PASW034372Medicare ID - Type Unspecified