Provider Demographics
NPI:1427138692
Name:SWAIM, ROBIN (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SWAIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167639
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-7639
Mailing Address - Country:US
Mailing Address - Phone:419-691-7213
Mailing Address - Fax:419-691-9107
Practice Address - Street 1:3634 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3443
Practice Address - Country:US
Practice Address - Phone:419-691-7213
Practice Address - Fax:419-691-9107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH350025625OtherRAILROAD MEDICARE
OH341702965-00OtherBWC
OH3417029655001OtherBC/BS
OH03278OtherPARAMOUNT
OH0858899Medicaid
OH3417029655001OtherBC/BS
OH0714761Medicare PIN