Provider Demographics
NPI:1992315352
Name:SWARTZ, MICHAEL (AGNP-C)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 VERLEN DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-7761
Mailing Address - Country:US
Mailing Address - Phone:704-856-3260
Mailing Address - Fax:
Practice Address - Street 1:138 DUBLIN SQUARE RD STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8601
Practice Address - Country:US
Practice Address - Phone:336-610-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC215487363LP2300X
NC5013493363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care