Basic Information
| Provider Information | |||||||||
| NPI: | 1811318868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWAYNE | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8205 FEATHERHILL RD | ||||||||
| Address2: | APT. 202 | ||||||||
| City: | PERRY HALL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211289220 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9475 LOTTSFORD RD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | UPPER MARLBORO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207745357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016366504 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2013 | ||||||||
| LastUpdateDate: | 12/18/2013 | ||||||||
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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 | 163W00000X | R208651 | MD | Y | Nursing Service Providers | Registered Nurse |
No ID Information.