Provider Demographics
NPI:1902891880
Name:SWENSON, BRETT E (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:E
Last Name:SWENSON
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:PO BOX 27093
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0134
Mailing Address - Country:US
Mailing Address - Phone:480-751-2345
Mailing Address - Fax:480-751-2341
Practice Address - Street 1:8585 E HARTFORD DR STE 900
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5475
Practice Address - Country:US
Practice Address - Phone:480-751-2345
Practice Address - Fax:480-751-2341
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33760207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ949852Medicaid
AZ949852Medicaid
AZI39646Medicare UPIN