Healthcare Provider Details

I. General information

NPI: 1033912597
Provider Name (Legal Business Name): DAVID JAMES SPOUGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

884 20TH STREET
WEST VANCOUVER BC
V7V 3Y8
CA

IV. Provider business mailing address

884 20TH STREET
WEST VANCOUVER BC
V7V 3Y8
CA

V. Phone/Fax

Practice location:
  • Phone: 604-764-2351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number25079
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25079
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25079
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: