Healthcare Provider Details

I. General information

NPI: 1699018010
Provider Name (Legal Business Name): GREGORY MICHAEL SPRUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 S DOWNING ST
DENVER CO
80210-5847
US

IV. Provider business mailing address

1745 N MILLS AVE STE 100
ORLANDO FL
32803-1876
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-1065
  • Fax: 303-733-1699
Mailing address:
  • Phone: 407-841-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2016-01166
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME139817
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDR.69443
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: