MEDICARE: STEPHANIE H SPYTEK 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	207V00000X	Obstetrics & Gynecology Physician	0101256383	VA

General Provider Information

NPI Number	:	1306878954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE H SPYTEK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 748613
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7915 LAKE MANASSAS DR STE 205
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3260
Country	:	US
Telephone Number	:	571-261-3529
Fax Number	:	703-753-5613

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	02/24/2023

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