Provider Demographics
NPI:1053168955
Name:SWAIN, HEATHER ASHLEY VICTORIA (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ASHLEY VICTORIA
Last Name:SWAIN
Suffix:
Gender:F
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:PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7593
Mailing Address - Country:US
Mailing Address - Phone:919-966-6770
Mailing Address - Fax:984-974-9609
Practice Address - Street 1:118 KNOX WAY
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-6610
Practice Address - Country:US
Practice Address - Phone:984-215-5900
Practice Address - Fax:984-215-5942
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SWAI-IOYGMW390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program