Swan, Mark Edward

Swan, Mark Edward is an individual health care provider with primary practice located at 1124 S State St Michigan College Of Optometry, Big Rapids MI 49307-2256. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Swan, Mark Edward can be contacted via phone (231) 591-2222.

Contact Information

Primary practice address
1124 S State St Michigan College Of Optometry Big Rapids MI 49307-2256
Phone: (231) 591-2222
Fax: (231) 591-3991
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003186 Michigan

Profile Details

NPI number 1386665016
LBN Legal business name Swan, Mark Edward
Credentials OD MED
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Aug 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386665016 NPPES
Michigan Other M5003186 BLUE CROSS
Michigan MEDICAID 4401840 BLUE CROSS
Michigan Other 999998001 BLUE CROSS
Michigan Other 900006367 BLUE CROSS

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