Healthcare Provider Details

I. General information

NPI: 1477796704
Provider Name (Legal Business Name): GARRICK SPEARS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM ST NE
WASHINGTON DC
20017-2104
US

IV. Provider business mailing address

PO BOX 2244
GERMANTOWN MD
20875-2244
US

V. Phone/Fax

Practice location:
  • Phone: 202-269-7001
  • Fax: 202-269-7825
Mailing address:
  • Phone: 810-252-8222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD040958
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: