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NPI Code Detail

MEDICARE: DR. MICHAEL P SPENCER MD

MEDICARE: DR. MICHAEL P SPENCER 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
1208C00000XColon & Rectal Surgery Physician30322MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386653947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL P SPENCER MD
Provider Business Mailing Address
First Line : 2550 UNIVERSITY AVE W STE 110N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55114-8693
Country : US
Telephone Number : 651-602-5312
Fax Number :
Provider Business Practice Location Address
First Line : 6363 FRANCE AVE S STE 400
Second Line :
City : EDINA
State : MN
Zip : 55435-2142
Country : US
Telephone Number : 651-312-1700
Fax Number : 952-920-4148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 08/04/2025

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Directions to “ DR. MICHAEL P SPENCER MD” Practice Location

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