Provider Demographics
NPI:1699746677
Name:SWARTZENDRUBER, FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:SWARTZENDRUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 BOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-1168
Mailing Address - Country:US
Mailing Address - Phone:540-921-2158
Mailing Address - Fax:540-921-2915
Practice Address - Street 1:430 BOXWOOD LN
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1168
Practice Address - Country:US
Practice Address - Phone:540-921-2158
Practice Address - Fax:540-921-2915
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010482892086S0129X, 208600000X
NC29680208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP01538127OtherMEDICARE RAIL ROAD
VA010035341Medicaid
VAP00277127OtherMEDICARE RAILROAD
VAP00277127OtherMEDICARE RAILROAD
NCNCE334BMedicare PIN