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NPI Code Detail

MEDICARE: SPENCER DYER MD

MEDICARE:   SPENCER  DYER  MD
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
12085R0202XDiagnostic Radiology Physician62745MN

General Provider Information

NPI Number : 1245785492
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER DYER MD
Provider Business Mailing Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number :
Provider Business Practice Location Address
First Line : 5169 S COTTONWOOD ST STE 303
Second Line :
City : MURRAY
State : UT
Zip : 84107-6768
Country : US
Telephone Number : 801-507-3750
Fax Number : 801-507-3799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2016
Last Update Date : 01/10/2024

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