Healthcare Provider Details

I. General information

NPI: 1659432235
Provider Name (Legal Business Name): JOSEPH EDWARD SPAHR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGH PARK AVE
GOSHEN IN
46526-4810
US

IV. Provider business mailing address

PO BOX 834
GOSHEN IN
46527-0834
US

V. Phone/Fax

Practice location:
  • Phone: 574-364-2888
  • Fax: 574-364-2590
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01054822A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: