Healthcare Provider Details

I. General information

NPI: 1174727234
Provider Name (Legal Business Name): KATHERINE A SPARGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 CLARKE RD
NEEDHAM MA
02492-1333
US

IV. Provider business mailing address

55 FRUIT STREET, FOUNDERS 528 MASSACHUSETTS GENERAL HOSPITAL, DIVISION OF NEONATOLOGY
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 773-339-8671
  • Fax:
Mailing address:
  • Phone: 617-643-6536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number228404
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number228404
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: