Swenson Healthcare of Ma, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SWENSON HEALTHCARE OF MA, PLLC

Practice address

222 State St
Ludlow, MA 01056-3437

Phone

(253) 300-8453

NPI assigned

Nov 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adnan M Dahdul, MD

Title

Sole MBR

Phone

(253) 300-8453

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1811598154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PACIFIC AVE STE 400",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024381",
            "telephone_number": "253-300-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATE ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010563437",
            "telephone_number": "253-300-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWENSON HEALTHCARE OF MA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "DAHDUL",
        "authorized_official_first_name": "ADNAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "253-300-8453",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S100693934",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.