MEDICARE: DR. DAVID ALLEN SPOTT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	D0015375	MD

General Provider Information

NPI Number	:	1033105457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALLEN SPOTT M.D.

Provider Business Mailing Address
First Line	:	9131 PISCATAWAY RD
Second Line	:	SUITE # 550
City	:	CLINTON
State	:	MD
Zip	:	20735-2508
Country	:	US
Telephone Number	:	301-868-7077
Fax Number	:	301-856-0767

Provider Business Practice Location Address
First Line	:	9131 PISCATAWAY RD
Second Line	:	SUITE # 550
City	:	CLINTON
State	:	MD
Zip	:	20735-2508
Country	:	US
Telephone Number	:	301-868-7077
Fax Number	:	301-856-0767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/08/2007

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