Healthcare Provider Details

I. General information

NPI: 1891754404
Provider Name (Legal Business Name): DAVID M SPECTOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JOHN DEERE ROAD SUITE 200
MOLINE IL
61265-6897
US

IV. Provider business mailing address

600 JOHN DEERE ROAD SUITE 200
MOLINE IL
61265-6897
US

V. Phone/Fax

Practice location:
  • Phone: 309-779-4200
  • Fax: 309-779-4305
Mailing address:
  • Phone: 309-779-4200
  • Fax: 309-779-4305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number33224
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number036101556
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: