Provider Demographics
NPI:1992888598
Name:SWAN, HARVEY FRANK (MD)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:FRANK
Last Name:SWAN
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 1:2616 SHERWOOD HALL LANE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3154
Mailing Address - Country:US
Mailing Address - Phone:703-780-8400
Mailing Address - Fax:
Practice Address - Street 1:2616 SHERWOOD HALL LANE
Practice Address - Street 2:SUITE 306
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3154
Practice Address - Country:US
Practice Address - Phone:703-780-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024189207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62622Medicare UPIN
SW409927Medicare ID - Type Unspecified