Basic Information
| Provider Information | |||||||||
| NPI: | 1265602148 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWEDA | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | GERARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | WALTER REED ARMY MEDICAL CENTER; BUILDING 6 | ||||||||
| Address2: | 6900 GEORGIA AVENUE, NW; BUILDING 6 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 203070001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027825899 | ||||||||
| FaxNumber: | 2027827165 | ||||||||
| Practice Location | |||||||||
| Address1: | WALTER REED ARMY MEDICAL CENTER; BUILDING 6 | ||||||||
| Address2: | 6900 GEORGIA AVENUE, NW; BUILDING 6 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 203070001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027825899 | ||||||||
| FaxNumber: | 2027827165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2008 | ||||||||
| LastUpdateDate: | 03/06/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY1000075 | DC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 0810001688 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 02616 | MD | N | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.